Risk factors of CVD

Age The risk of coronary atherosclerosis increases with age, but evidence suggests that the condition may start to develop very early in life. About four out of five people who die of coronary heart disease are age 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks. Sex Women before menopause rarely suffer from heart disease (the hormone oestrogen present in women appears to protect them.) Coronary heat disease mainly afflicts adult males and manifests itself in the middle ages (45-55 years old). Diet Individuals with hereditary high levels of blood cholesterol are more prone to develop coronary heart disease. The risk of coronary heart disease rises as blood cholesterol levels increase. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. A person's cholesterol level is also affected by age, sex and heredity. LDL/HDL Smoking Tends to increase blood cholesterol levels. Cigarette smokers also have raised fibrinogen levels and platelet counts, which make the blood stickier. Carbon monoxide attaches itself to haemoglobin much more easily than oxygen does. This reduces the amount of oxygen available to the tissues. All these factors make smokers more at risk of developing various forms of atherosclerotic disease. As the atherosclerotic process progresses, blood flows less easily through rigid and narrowed arteries and the blood is more likely to form a thrombosis. This sudden blockage of an artery may lead to a fatal heart attack, a stroke or gangrene. High blood pressure Increases the heart's workload, causing the heart to enlarge and weaken over time. It also increases the risk of stroke, heart attack, kidney failure and congestive heart failure. When high blood pressure exists with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack or stroke increases several times. Weight

People who have excess body fat - especially if a lot of it is in the waist area - are more likely to develop heart disease and stroke even if they have no other risk factors. Excess weight increases the strain on the heart, raises blood pressure and blood cholesterol and triglyceride levels, and lowers HDL ('good') cholesterol levels. It can also make diabetes more likely to develop. Heredity Coronary heart disease is much more common in some families than in others. As DNA determines the sizes of the arteries themselves it is probable that characteristics of the heart are passed on to offspring. Lack of exercise Regular exercise aids a healthy circulation, and the physically inactive are more at risk from heart disease. Other diseases Diabetes and high blood pressure increase the risk of coronary disease. Diabetes seriously increases the risk of developing cardiovascular disease. Even when glucose levels are under control, diabetes greatly increases the risk of heart disease and stroke. About two-thirds of people with diabetes die of some form of heart or blood vessel disease. Socio-economic disadvantage As nations become prosperous coronary heart disease becomes less of a problem for the well educated classes, and preferentially affects those in the lower social levels; poor housing and little education are strong indicators of high coronary mortality. Psychological and personality factors Sleep disturbances and stress are predictors of angina, infraction and death due to heart attacks.