Risk factors for cardiovascular diseases: Overview
Cardiovascular diseases remain a global healthcare problem as they are associated with both high morbidity and mortality being the most common cause of death worldwide. About half of these deaths occur as the result of coronary artery disease and approximately 20% happens due to stroke. The socioeconomic burden of cardiovascular diseases is even greater as they are associated with significant disability incidence. Nevertheless, cardiovascular diseases can be effectively prevented or delayed once the major risk factors are addressed.
What are the risk factors?
Risk factors are the individual’s features, traits (including inherited factors) and behavioral patterns which are associated with increased risk of developing certain disease/diseases in the future. Some of the risk factors can be modified by changing the lifestyle, diet or by taking some pills, whereas the other risk factor known as unmodifiable risk factors such as genetic patterns, age, and gender cannot be changed. Therefore, it is recommended to address the so-called modifiable risk factors by changing one’s habits, behavior, and lifestyle in order to prevent cardiovascular diseases.
- Non-modifiable risk factors are:
- Age – the incidence of cardiovascular disorder grows as a function of age;
- Male sex, although women at menopause are more likely to develop cardiovascular diseases;
- Family history of cardiovascular disorders (genetic factors);
- Cardiovascular diseases risk is somewhat higher in Negroids;
- Modifiable risk factors include:
- Sedentary lifestyle;
- Alcohol abuse;
- Coffee consumption;
- Diet high in fats;
- High salt intake;
Smoking is considered one of the most important risk factors for cardiovascular diseases. Furthermore, passive exposure to cigarette smoke also increases cardiovascular risk. According to the current studies, the risk of developing coronary artery disease increases two/threefold in individuals who consume more than 20 cigarettes per day, although even smoking a few cigarettes still increases the risk.
Smoking boosts the formation of atherosclerotic plaques by several mechanisms. It is thought that smoking reduces the high-density lipoproteins concentration in the blood, impairs dilatation of the vessels, promotes endothelium inflammation and causes platelet aggregation.
Smokers are also prone to experience spasm of the coronary arteries and are more likely to develop ventricular arrhythmia. Smoking cessation is the only effective method to reduce cardiovascular risk by about 65%.
Daily consumption of one alcoholic beverage per day is considered safe, some scientists suggest that it may be even protective against cardiovascular diseases. However, a high level of alcohol consumption (more than 3 drinks per day)is known to cause alcoholic cardiomyopathy and may cause a stroke. The total risk of cardiovascular diseases increases drastically, the heart and the blood vessels are severely damaged and the risk of death rises.
Consumption of 1 to 5 of coffee per day is associated with a 3-fold increased risk of hypertension. Caffeine increases diastolic blood pressure by 3 mmHg in persons with previously normal blood pressure and by 8 mmHg in those with already existing hypertension.
Regular exercises increase the heart’s ability to sustain exercises and decrease oxygen demand by the heart muscle thereby reducing the cardiovascular risks by 40%. It is recommended to do at least 150 mins of moderate-intensity aerobic physical exercises or alternatively 75 minutes of moderate and vigorous-intensity activity.
Diet, obesity and metabolic syndrome
Diet high in saturated animal fats and trans-fatty acids is associated with increased risk of atherosclerosis. High dietary salt intake is also related to increase risk of hypertension and worsen the course of the chronic heart disease.
Metabolic syndrome is associated with an increased risk of cardiovascular disease. This complex condition is diagnosed when a person has at least 3 of the following symptoms:
- Fasting blood glucose of more than 110 mg/dL;
- Blood pressure > 130/85 mmHg;
- Triglycerides ≥ 150 mg/dL;
- HDL cholesterol <40 mg/dL for men or <50 mg/dL for women;
- Waist >40 inches for men or >35 inches for women;
Obesity is associated with a 2 to 6-fold increased risk of hypertension. In general, maintaining a healthy body weight (body-mass index should be 20- 25 kg/m2) is one of the best measures to prevent cardiovascular diseases or delay the worsening of the already existing disease.
High cholesterol levels are considered one of the major risk factors for the ischemic heart disease – it is responsible for about 60% of cases of ischemic heart disease. The high prevalence of dyslipidemia is related to high consumption of dietary animal fats, although sometimes dyslipidemia develops due to genetic disorders of lipid metabolism.
Worldwide diabetes mellitus incidence increases gradually. Impaired glucose metabolism influences on the blood vessels, damages the kidneys, brain and the heart.
Adequate blood glucose control is essential to avoid complications and prevent cardiovascular diseases.
High blood pressure is associated with an increased risk of stroke and myocardial infarction. Even so little as 7 mm Hg elevation of diastolic blood pressure drastically increases the risk for cardiovascular catastrophes/events. Isolated systolic hypertension (high systolic blood pressure) also increases the risk of cardiovascular death.
Therefore, hypertension treatment and, namely, decreasing the diastolic blood pressure effectively reduces the risk of stroke and vascular mortality.
Genetic testing may be helpful to estimate one’s risk in order to be aware of the risk and take action on managing the other, modifiable, risk factors.