Risk factors for cardiovascular disease

The circumstances that make a person more or less likely to develop conditions affecting the HEART and cardiovascular system. A risk factor may be fixed, or immutable, such as age, ethnicity, or gender. Other risk factors are variable, or mutable. These are the risk factors that an individual can influence, such as dietary habits and physical activity. Doctors also use the terms alterable and nonalterable, respectively. Other health conditions may also become risk factors for CARDIOVASCULAR DISEASE (CVD), notably DIABETES. Certain cardiovascular conditions, such as HYPERTENSION (high BLOOD PRESSURE) and ATHEROSCLEROSIS, are risk factors for other cardiovascular conditions such as STROKE and HEART ATTACK.

male cigarette smoking
age 60 and older OBESITY
genetic predisposition physical inactivity
African American heritage HYPERLIPIDEMIA (elevated blood lipid levels)
Native American heritage HYPERTENSION (high BLOOD PRESSURE)
female postmenopause DIABETES

More than 90 percent of cardiovascular disease among Americans develops over decades, the consequence of interactions between genetic predisposition and lifestyle. Health experts believe lifestyle choices can prevent nearly all of such acquired cardiovascular disease, even when there are genetic influences. The HUMAN GENOME PROJECT, the mapping of the human genome, has broadened scientific understanding of genes and of how they influence health and disease. Researchers are better able to assess and even manipulate the interplay between certain genetic factors and lifestyle factors. One area of ongoing genetic research is ethnicity. Though the rate of CVD is significantly higher among people of certain ethnic heritages, the reasons remain unclear.

Though individuals cannot alter genetic predisposition for health conditions, they can often mitigate, through lifestyle, the ways in which such predispositions play out in their lives. A person who has a family history of early-onset atherosclerosis, for example, may mitigate the effects of this genetic predisposition through daily moderate exercise (aerobic and STRENGTH) and dietary habits that limit fat consumption to less than 10 percent of daily calories and increased fiber consumption, as well as through maintaining healthy body weight. Other preventive measures may include frequent blood lipid level screening (every 6 to 12 months) and lipid-lowering medications for lipid levels that remain elevated despite lifestyle efforts to keep them low. These lifestyle efforts can minimize, and often prevent, cardiovascular disease.

An important dimension to risk factors for CVD is the interplay that exists among them. Physical inactivity is a key element in the development and progression of HYPERLIPIDEMIA, type 2 DIABETES, OBESITY, and hypertension. Hyperlipidemia lays the foundation for atherosclerosis, which progresses to CORONARY ARTERY DISEASE (CAD). CAD causes ISCHEMIC HEART DISEASE (IHD) and is the leading cause of heart attack. Hypertension, alone though especially in combination with atherosclerosis (CAD or PVD), is the leading cause of stroke.

Congenital Heart Conditions

Congenital heart conditions, even those repaired in early childhood, may predispose people to other forms of cardiovascular disease later in life. Adults under age 30 are the first generation for whom surgical correction of congenital heart defects was a viable treatment option. Doctors do not yet know the extent to which these anomalies may affect future cardiovascular risk.

Many health experts question whether the risk of age is more a reflection of cumulative variable risks than itself an independent risk factor. Targeting individual risk factors early in life, before substantial cardiovascular disease develops, is the most effective preventive measure. Once a cardiovascular condition begins, preventive efforts shift focus to slow the progression of disease.


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