Cardiovascular Disease Risk Factors

Cardiovascular Disease Risk Factors

• Modifiable risk factors include hypertension, dyslipidemia, smoking, alcohol misuse, unhealthy diet, physical inactivity, and psychosocial factors.
• Non-modifiable risk factors comprise genetic predisposition, race/ethnicity, gender, and age.
• Cardiovascular disease (CVD) risk factors can differ by a patient's sex or race.
• Many CVD risk factors can be changed.

Framingham Heart Study (FHS)

• The FHS began in 1948 with 5,209 participants aged 30-62 in Framingham, Massachusetts.
• Researchers conducted physical exams and lifestyle interviews.
• The FHS analyzed patterns related to CVD development.
• The study is currently in its 3rd generation, including the original participants, their children, and their grandchildren.
• The FHS has been cited in 6,000+ medical journal articles.
• Through the FHS, researchers learned about CVD risk factors and that many can be changed.
• Implications for CVD risk stratification/treatments include routine physical exams where doctors check BP, cholesterol, eating patterns, smoking status, physical activity, and body weight.

Smoking

• Cigarette smoking and tobacco use increase CVD risk.
• Smoking is responsible for approximately 25% of CVD deaths in Canada.
• The prevalence of smoking has decreased over the past four decades.
• Vaping and cannabis use (smoking, eating, vaping) also increase CVD risk.

Physical Inactivity

• Approximately 50% of Canadian adults are physically inactive (2005 data).
• Inactivity prevalence is higher in women and increases with age.
• Self-reported data likely overestimates inactivity.
• Objective measures using accelerometers suggest a higher inactivity rate (~97% in the US).

Diet (Poor)

• Excessive intake of saturated fats, cholesterol, and sodium are relevant dietary markers.
• Approximately 90% of adults do not meet recommended saturated fat targets.
• 50% of men and 25% of women do not meet recommended dietary cholesterol targets.
• 90% of men and 65% of women exceed the recommended sodium upper limit.
• Poor diet negatively impacts CVD risk.

Excessive Alcohol Consumption

• Excessive alcohol intake increases CVD risk.
• Patterns of drinking (moderate vs. binge >6 drinks/session) affect risk.
• Guidelines for alcohol consumption in 2023 redefined moderate drinking.
• Prevalence of heavy drinking Canadians increased over 50% from 1995-2005.
• In 2018, 19.1% of Canadians (~5.9 million) reported heavy drinking.

Psychosocial Factors

• Factors like depression, work stress, and low social support increase CVD risk.

Overweight and Obesity

• Overweight and obesity involve elevated body weight beyond the normal range due to excessive adipose tissue accumulation.
• Overweight and obesity raise CVD risk, linked to dyslipidemia, hypertension, diabetes, and emerging risk factors.
• BMI (body mass index) is a measure of weight for height but does not distinguish between fat and lean tissue.
• Abdominal obesity contributes to excess visceral fat accumulation, increasing CVD risk.
• Rates of overweight and obesity have increased. In 2004, 6 out of 10 Canadian adults were overweight or obese.

Dyslipidemia

• Abnormal blood lipid profiles increase CVD risk.
• High total cholesterol, high low-density lipoprotein (LDL), low high-density lipoprotein (HDL), high TC/HDL ratio, and high triglycerides are problematic.
• Dyslipidemia's significance as a major CVD risk factor depends on individual global risk factors (cumulative impact of all risk factors).

Hypertension

• 17% of Canadian adults have hypertension (HTN).
• Prevalence of HTN increases with age.
• Elevated blood pressure (BP) leads to organ system changes, increasing CVD risk (stroke, retinopathy, peripheral artery disease, heart failure, and chronic kidney disease).
• Hypertension is often a "silent killer," with few symptoms until advanced stages.
• Improvement in hypertension control rates has been observed in recent decades.

Diabetes Mellitus (DM)

• Diabetes mellitus (DM) increases CVD risk.
• DM is considered equivalent to other CVD risk conditions (like an established CVD disease).
• Types 1 and 2 (T1DM and T2DM) are present, with T2DM being the most frequent type.
• Older adults have the highest prevalence of DM.
• In 2005/06, 5.9% of the Canadian population had DM.

Emerging Risk Factors

• Ongoing research identifies emerging risk factors for CVD that are not routinely screened.
• These factors include High C-Reactive Protein (CRP), High Fibrinogen, High Lipoprotein(a) (Lp(a)), High Lp(a), among others.

Summary of Trends

• Smoking rates are decreasing, while hypertension, diabetes, obesity, and inactivity rates are likely increasing.

This quiz focuses on risk factors for cardiovascular disease (CVD). It explores the impact of physical activity, dietary habits, and modifiable and non-modifiable factors. Also examines the role of psychosocial factors, obesity, and findings from studies like the Framingham Heart Study.