How to predict risk of heart attack
Risk factors of coronary artery disease
You are at a greater risk for angina pectoris (heart pain) and Myocardial infarction (heart attack) if you/your
1. are male
2. smoke cigarettes
3. have high blood pressure
4. have diabetes
5. are inactive
6. are overweight
7. have high blood cholesterol
8. father/mother have coronary heart disease
9. are of Type A personality (very ambitious and competitive).
What is risk factor?
A risk factor may be defined broadly as any habit or trait that can be used to predict an individual’s probability of developing coronary heart disease (1). A rise factor so defined may be a causative agent of the disease. A more limited and specific definition is that a risk factor is a causative agent or condition that can be used to predict an individual’s probability of developing disease. In most instances, a risk factor is the trait that predicts of development of clinically significant disease within a population. In most of the cases, it is involved in the causation of the disease. There are four very important risk factors for the causation of heart attack. These are cigarette smoking, high blood pressure, diabetes mellitus and high blood cholesterol level (2-5).
Risk factors of heart attack?
Increasing knowledge of risk factors in coronary artery disease has enabled us to identify them in individuals and in communities. It is therefore possible and desirable to correct or modify them so as to reduce the incidence of heart attack. There are two types of coronary risk factors; non modifiable risk factors and modifiable risk factors. Those risk factors which you can not reverse are called non-modifiable risk factors or in other words, you are born with some of those risks. Those risk factors which you can correct by drugs or by changing lifestyle are called modifiable risk factors.
A. Non-modifiable risk factors include:
1. Masculine gender
2. Increasing age
3. Family history of heart attack
B. Modifiable risk factors include :
1. High blood pressure
2. Diabetes mellitus
3. Smoking
4. High blood fat
5. Overweight
6. Physical inactivity
7. Stressful life
The effect of combined factors is not an additive but a multiplying one. For example a person with untreated high blood pressure is twice as likely to get heart attack compared with someone with normal pressure. If he also suffers from diabetes his chances of developing heart attack is five fold; and if he is also a heavy smoker, her is nine times more likely to get ischaemic heart disease (6). Modification of risk factors has already been proven to be effective in reducing the incidence of coronary heart disease in population studies. For an individual, preventive measures must be targeted towards modifying his risk factors in a manner which is practical and acceptable. If he has high blood pressure, is a heavy smoker and has high blood fat, all three factors can be tackled all together. For the community the approach must be multifactor and sustained.
References
1. Report of the working group on atherosclerosis of the national heart, lung, and blood institute. Vol 2. DHEW Publication No. (NIH) 82-2035 Washigton D.C. US Government printing office, 1981.
2. Ross R. The pathogenesis of atherosclerosis –an update. N Engl J Med 1986; 488: 1986
3. Smoking and health. Chap. 3 Criteria for judgment. DHEW publication No NIH 1103, Washington D.C US Government printing office. 1964.
4. Jacoby RM, Nesto R. Acute myocardial infarction in the diabetic patient: pathophysiology, clinical course and prognosis. J Am Coll Cardiol 1992; 20 : 736-744.
5. Lipid research clinics program. The lipid research clinics coronary primary prevention trial result: II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 1984; 251 : 365.
6. Health book on heart proplems. Singapore National Heart Association, 1992.
