Coronary Risk Factors

Coronary Risk Factors

Alternate Names

  • coronary heart disease risk factors
  • Normal Heart

Definition

Coronary risk factors are those conditions or diseases that increase a person's risk of developing coronary heart disease, or CHD. Someone with CHD has a blockage in the arteries that supply blood, oxygen, and nutrients to the heart.

What is the information for this topic?

CHD is the number one cause of death in many developed countries. It is also associated with a higher risk of:
  • arrhythmias, or irregular heartbeats. These are caused by a damage to the electrical system of the heart.
  • chest pain, which can be stable angina or unstable angina
  • congestive heart failure, a condition in which the weakened heart is unable to pump enough blood to body organs
  • heart attack, which occurs when blockage of the heart arteries becomes severe and cuts off the circulation of fresh blood
A person's risk of developing CHD within 10 years is determined by using information from the Framingham Heart Study. This 10-year risk is calculated from a formula that looks at the following:
  • age
  • cigarette smoking
  • HDL cholesterol (also called "healthy" or "good" cholesterol)
  • total cholesterol
  • systolic blood pressure, which is the top number on a blood pressure reading
  • total cholesterol
  • treatment for high blood pressure

Even though the Framingham estimates use total cholesterol as opposed to LDL cholesterol, LDL cholesterol remains the primary target of therapy to prevent CHD.

The National Cholesterol Education Project lists five major risk factors for CHD other than LDL cholesterol:

  • age (men 45 years of age or older, women 55 years of age or older)
  • blood pressure (systolic blood pressure of 140 or higher OR diastolic blood pressure of 90 or higher OR being treated for hypertension or high blood pressure with medication)
  • smoking status (current smoker)
  • premature family history of CHD (CHD in a male first degree relative younger than 55 years old or CHD in a female first degree relative younger than 65 years old)
  • low HDL cholesterol (less than 40 mg/dL)
People who already have CHD and those who have certain conditions called CHD "risk equivalents" are at the greatest risk of having a major heart-related problem. A person with CHD risk equivalents has the same level of risk for a major heart-related problem as someone who already has heart disease.
CHD "risk equivalents" include:
  • diabetes
  • other clinical signs of atherosclerosis. These include peripheral arterial disease, abdominal aortic aneurysm, or certain types of carotid artery disease
  • the presence of multiple risk factors that give the person a greater than 20% chance of developing CHD within 10 years based upon the Framingham Risk Calculations

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

Cecil's Textbook of Medicine, 1996, Bennett et al.

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