Risk Factors of Ischemic Heart Disease!

Risk factors of ischemic heart disease

Ischemic heart disease (IHD) is the leading cause of death in adults in the United States, accounting for roughly 610,000 fatalities each year. More than 90% of IHD cases occurred in those who had at least one risk factor. The lack of major risk factors, on the other hand, suggests a substantially reduced probability of myocardial ischemia. This article will go through numerous risk factors for Ischemic heart disease, how to prevent them if they are controllable, and discuss IHD in women.

A higher chance of heart attack has been related to a number of risk factors. Studies classify CAD into two broad categories: non-modifiable and modifiable risk factors. Many risk factors for myocardial infarction are modifiable, and they account for the bulk of the population's attributable risk (MI)

Hypertension, diabetes, hyperlipidemia, cigarette use, diet, and physical inactivity are all modifiable risk factors. Age, gender, family history, socioeconomic status, and ethnicity are non-modifiable risk factors.

• Non-Modifiable risk factors
• Age :

• Your risk of cardiovascular disease(CVD) rises as you become older. Men's CVD occurrence rises after 45 years, whereas women's risk rises after 55 years.
• Even when there is no disease, aging is connected to cardiovascular disease as your heart acts less efficiently as you age, your heart muscle weakens, and your heart's pumping chambers may become stiff.

• Gender

In comparison to women, men are at a higher risk. Due to a decline in estrogen levels, this percentage drops after women reach menopause, increasing the risk for women until it matches that of males. After the age of 65, the risk for heart disease is about the same between the sexes when other risk factors are similar.

• Family history:

Your particular risk is strongly influenced by your family's history of cardiovascular disease. A positive family history of heart disease in your father or brother diagnosed before the age of 55 and your mother or sister diagnosed before the age of 65 is generally associated with a twofold increase in the risk of CVD.

• Ethnicity

Many genes are shared by people of the same ethnicity. African Americans, Hispanics, and Southeast Asians have been shown to have an elevated risk of ischemic heart disease morbidity and mortality in studies.

• Socio-economic status

Evidences suggested that people from lower/middle social classes were in greater CHD risk than higher social classes.

• Modifiable risk factors

The following modifiable risk factors have a major role in the development of IHD, and individuals with the optimal risk factor profiles had a much reduced probability of premature death from cardiovascular events.

• Hypertension

Hypertension affects around one out of every three individuals. Because of the oxidative and mechanical stress imposed on the artery wall, hypertension is considered a major risk factor for heart disease. As a consequence, lowering systolic and diastolic blood pressure by more than 10 and 5 mmHg, respectively, resulted in a substantial absolute risk reduction in cardiovascular events.

Alert

When systolic blood pressure is maintained at a goal of 130mmHg, the risk of IHD is reduced.

• Hyperlipidemia
• As increased triglycerides have been linked to coronary artery disease, hyperlipidemia is regarded as the second most frequent risk factor for ischemic heart disease.
• It’s recommended to use statin for the primary prevention of cardiovascular disease between 40 to 75 years of age.
• The following lipid and lipoprotein abnormalities are associated with increased IHD risk:

• Elevated total cholesterol and elevated LDL (bad cholesterol)
• Low HDL cholesterol (good cholesterol)
• Hypertriglyceridemia

• Diabetes mellitus:

• According to the Centers for Disease Control and Prevention, more than one out of every three adult patients in the United States has prediabetes, which puts them at risk of developing type 2 diabetes and heart disease. Furthermore, cardiovascular disease is the major cause of morbidity and death in diabetic individuals.

• The risk for heart disease rate is 2.5 times higher in diabetic adult patients compared to those without diabetes.

• Obesity:
• Obese people are twice as likely to have coronary heart disease, and they are also more prone to acquire additional IHD risk factors such as hypertension, hyperlipidemia, and diabetes mellitus.
• Obesity is linked to more complicated, elevated atherosclerotic coronary artery lesions.
• Even a small 5% body weight decrease in obese or overweight people might result in clinically significant health advantages.

• Smoking:

Smoking doubled the risk of cardiovascular disease in current smokers and increased the risk by 37% in former smokers over the age of 60.

Note:

The risk of coronary artery disease drops to a level of lifetime nonsmokers within four years of quitting.

• diet:

• Fat raises the risk of cardiovascular disease through impairing endothelial function, insulin resistance, and inflammation.
• There is growing evidence suggesting that High fiber intake, fruit and vegetables consumption are also associated with a reduction in the risk of IHD.
• The DASH, Mediterranean, and vegetarian diets offer the most benefits for preventing cardiovascular disease. Furthermore, in people with hypertension, the DASH diet can lower systolic blood pressure by up to 11.5 mmHg.

• Sedentary lifestyle:

• Exercise is a protective factor in the prevention of IHD, resulting in decreased morbidity and death. This is due to increased endothelium nitrous oxide production and more efficient inactivation of reactive oxygen species.
• Physical activity is advised by doctors for individuals who are overweight or have other IHD risk factors. The risk of cardiovascular disease is reduced by 150 minutes of moderate-intensity aerobic exercise each week.

Women and coronary artery disease (CAD):

• Despite the fact that males are at a higher risk of coronary artery disease than women, it is remains the top cause of mortality in women. One out of every three female fatalities was caused by cardiovascular disease.

• Estrogen is thought to have a protective role by promoting plaque stabilization via an anti-inflammatory effect on atherosclerosis.

Aspirin in primary prevention:

Aspirin has long been used to prevent atherosclerotic cardiovascular disease. Aspirin is indicated for individuals aged 50 to 59 who have a 10-year risk of atherosclerotic cardiovascular disease but no bleeding risk factors.

The American Heart Association promote seven ideal cardiovascular health metrics, including:

• Not smoking
• Physically active
• Normal blood pressure
• Normal blood glucose level
• Normal total cholesterol level
• Normal weight
• Healthy diet

Conclusion

In most developed countries, cardiovascular disease (CVD) is the major cause of mortality. Identification of risk factors, along with advancements in medical technology, has resulted to a considerable drop in CAD death rates in Western countries during the last forty years. Many CVD risk factors are controllable through particular preventative interventions, providing a potential to minimize the global CVD burden.

References

1. Bisciglia, A., Pasceri, V., Irini, D., Varveri, A., & Speciale, G. (2019). Risk Factors for Ischemic Heart Disease. Reviews on recent clinical trials, 14(2), 86-94.
2. Brown, J. C., Gerhardt, T. E., & Kwon, E. (2020). Risk factors for coronary artery disease.
3. Rapsomaniki E, Timmis A, George J, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people. Lancet 2014; 383:1899.
4. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364:937.