Key Risk Factors for Cardiovascular Disease by Richard Zelman, MD

 

Cardiovascular disease (CVD) refers to conditions affecting both your heart and circulatory systems, such as high blood pressure, diabetes, and coronary artery disease. While genetics play an essential role, leading a healthy lifestyle may help lower your risk of CVD.

Age, sex, and family history of early heart disease cannot be changed; however, other risk factors can be reduced through diet, exercise, and medication.

Age

Richard Zelman  MD, highlights that cardiovascular diseases (CVDs), including heart attacks and strokes, are the leading cause of global mortality. Though CVDs can be avoided and treated through lifestyle modifications and medications, their risk increases with age. However, certain modifiable factors like smoking can be altered easily, and others like poor diet, physical inactivity, and alcohol abuse may take more effort to modify.

One piece of research sought to evaluate the impact of certain modifiable risk factors on cardiovascular events and mortality among Chinese adults. The results of a nationwide prospective cohort study illustrated how much CVD can be attributed to modifiable risk factors, with their effects differing among age groups.

Metabolic risk factors made up the most significant portion among deaths among participants aged 40-55 years, with hypertension being the key contributor. By comparison, lifestyle and socioeconomic risk factors made up more of the deaths among participants aged 55-75 years, with poor sleep duration and low education being critical contributors to this figure. These results support age-specific risk factor profiles as the foundation of accurate prediction, early detection, and customized interventions targeted toward specific aging populations.

Gender

Studies often fail to account for gender-specific effects and the relationship between specific risk factors and clinical endpoints; this often leads to misinterpretation of data - as shown by a male-to-female mortality ratio of 2.5-4.5 for coronary heart disease (CHD). Furthermore, cardiovascular specialists tend to prescribe guideline-recommended drugs less frequently for women after heart attacks, contributing to more symptoms as well as an increase in mortality in this population.

Although some differences between male and female CVD phenotypes can be explained by biological mechanisms, such as gene or hormone levels, their relative contribution remains undefined. It will also be essential to take gender-based influencing mechanisms as well as sociocultural dimensions of biological sex into consideration in future investigations of risk factors, as suggested by Richard Zelman, MD.

Gender-specific influences often arise during life events such as pregnancy complications, breast cancer therapy, or rheumatic diseases. Psychosocial influences have also been shown to vary according to gender; lifestyle choices and stressors differ according to gender; for instance, a higher risk of cardiovascular disease due to chronic psychosocial stress is observed among women than men and work-related stress has more negative health repercussions for female employees than their counterparts in male employees; therefore gender-specific concepts and a clear definition of biological sex must be developed to implement SDOH within patient management strategies effectively.

Family History

An increased family history of heart disease, particularly premature coronary artery disease, is linked to an increased risk of future cardiovascular events; however, its precise strength remains unknown as detailed family histories cannot always be collected due to various constraints, particularly in low and middle-income countries, as mentioned by Richard Zelman, MD.

According to the perspective of Richard Zelman, MD, offspring who reported parents with premature cardiovascular disease had significantly higher risks for offspring cardiovascular events compared to those without such histories, with 8-year event rates increasing steadily as predicted risk increased. Parental history is emerging as the strongest predictor of cardiovascular event risks after controlling for conventional individual risk factors and various nontraditional and traditional risk factors.

At least one first-degree relative with early-onset heart disease was linked with an almost doubling of cardiovascular risk among men and a 70% increase in risk among women after taking into account traditional and other risk factors; this finding highlighted the significant contribution familial history can make in assessing cardiovascular disease risk.

Lifestyle

Many risk factors for cardiovascular disease, including blood pressure, cholesterol levels, and body weight, can be modified.

As highlighted by Dr Richard Zelman, MD, modifiable risk factors can be altered through lifestyle modifications, such as giving up smoking, or switching to eating healthily. They also include physical activity and stress management.

Behavioral risk factors include unhealthy lifestyle choices like smoking, poor diet, and insufficient physical activity. These risk factors often overlap - for instance, secondhand smoke exposure increases your risks of high blood pressure, unhealthy cholesterol levels, and diabetes.

Eating a diet high in fruits and vegetables, whole grains, and fish and low in saturated fats and salt lowers cardiovascular disease risk; medication for high blood pressure, cholesterol, or diabetes may also help.

Health policies that foster a culture of wellness provide incentives to make healthier choices, and support individuals to sustain these behaviors are invaluable in combating cardiovascular diseases such as heart attacks and strokes in our globalized world.