Risk Factors for Atherosclerotic Coronary Artery Disease:
1. Dyslipidemias; particularly high low density cholesterol (LDL-C) and low high density cholesterol (HDL-C). (ATP III classification of LDL, total and HDL cholesterol; LDL: Optimal < 100 mg/dL, Near or above optimal 100-139 mg/dL, Borderline high 140-159 mg/dL, High > 160 mg/dL. Total cholesterol: Desirable < 200, borderline high 200-239 mg./dL, High > 240 mg./dL. HDL: Low < 40 mg./dL. JAMA. 2001;285:2486-2497)
2. Hypertension (50 million in the US, 1/3 undiagnosed, 3/4 under treated). (Classification of HTN Normal BP: systolic < 120 mmHg AND diastolic < 80 mmHg, Prehypertension: systolic 120-139 OR diastolic 80-89 mmHg, Hypertension: systolic > 140 OR diastolic > 90 mmHg. The JNC 7 Report JAMA. 2003;289:2560-2571)
3. Diabetes mellitus (8% of US population). (Classification: Normal fasting glucose < 110 mg/dL, Impaired 110-≤ 126 mg/dL, Diabetes > 126 mg/dL)
1. Dyslipidemias; particularly high low density cholesterol (LDL-C) and low high density cholesterol (HDL-C). (ATP III classification of LDL, total and HDL cholesterol; LDL: Optimal < 100 mg/dL, Near or above optimal 100-139 mg/dL, Borderline high 140-159 mg/dL, High > 160 mg/dL. Total cholesterol: Desirable < 200, borderline high 200-239 mg./dL, High > 240 mg./dL. HDL: Low < 40 mg./dL. JAMA. 2001;285:2486-2497)
2. Hypertension (50 million in the US, 1/3 undiagnosed, 3/4 under treated). (Classification of HTN Normal BP: systolic < 120 mmHg AND diastolic < 80 mmHg, Prehypertension: systolic 120-139 OR diastolic 80-89 mmHg, Hypertension: systolic > 140 OR diastolic > 90 mmHg. The JNC 7 Report JAMA. 2003;289:2560-2571)
3. Diabetes mellitus (8% of US population). (Classification: Normal fasting glucose < 110 mg/dL, Impaired 110-≤ 126 mg/dL, Diabetes > 126 mg/dL)
4. Smoking (most important modifiable risk factor), CAD accounts for 35%-40% of all smoking related deaths
5. Family history of premature coronary artery disease (CAD); First degree male relatives < 55 years or females < 65 years.
6. Obesity (18% of US population) and lack of exercise
7. Male sex and advanced age
8. Others (20% of CAD occurs in individuals without any of the classical risk factors); homocysteinemia, high sensitivity C reactive protein (hs-CRP), Fibrinogen, Lipoprotein a (Lpa), infection (? Chlamydia pneumoniae)
The metabolic syndrome is a recently identified entity that is associated with an increase in the risk of developing diabetes mellitus, cardiovascular disease and mortality from all causes. It is found in 22%-24% of the US population. Individuals with three or more of the following high risk features are defined as having the
metabolic syndrome;
5. Family history of premature coronary artery disease (CAD); First degree male relatives < 55 years or females < 65 years.
6. Obesity (18% of US population) and lack of exercise
7. Male sex and advanced age
8. Others (20% of CAD occurs in individuals without any of the classical risk factors); homocysteinemia, high sensitivity C reactive protein (hs-CRP), Fibrinogen, Lipoprotein a (Lpa), infection (? Chlamydia pneumoniae)
The metabolic syndrome is a recently identified entity that is associated with an increase in the risk of developing diabetes mellitus, cardiovascular disease and mortality from all causes. It is found in 22%-24% of the US population. Individuals with three or more of the following high risk features are defined as having the
metabolic syndrome;
1. Abdominal obesity: waist circumference >102 cm in men and >88 cm in women
2. Hypertriglyceridemia: 150 mg/dL
2. Hypertriglyceridemia: 150 mg/dL
3. Low high-density lipoprotein (HDL) cholesterol: <40 mg/dL in men and <50 mg/dL in women
4. High blood pressure: 130/85 mm Hg
5. High fasting glucose: 110 mg/dL ( 6.1 mmol/L).
4. High blood pressure: 130/85 mm Hg
5. High fasting glucose: 110 mg/dL ( 6.1 mmol/L).
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