Coronary Heart Disease Risk Factors - Part I
Identifying people with a high risk

Chances are that sometime in your life, you will be evaluated by your physician for CHD (Coronary Heart Disease). Indeed, according to official U.S. statistics, this is the major cause of adult death in the United States. Being at high risk may impact your decision on taking preventative medication such as Statins, modifying your lifestyle (eating, exercising, smoking,...). Our "Taking Statins" summary presents up-to-date information on the usefulness of taking such medication.

In general, the risk factors for CHD are well known, and have been published and reproduced in many mass-media outlets. They include having parents who had CHD at an early age, smoking, lack of exercise, obesity, high cholesterol (especially LDL), hypertension, getting old, and more.

The issue is how we can quantify these (and other) risk factors. It would be nice to come up with a single reliable number that easily separates high risk from low -­ a number that if one exceeds it, one would decide on preventive medication. Unfortunately the mechanisms that cause CHD are highly complex and their details are poorly understood. What we do have are several large studies involving may thousands of participants, that allow us to infer the average impact of many of the variables that contribute to CHD.

One of the oldest studies is the Framingham study . From its inception in 1948, it has had many important impacts on the field. Examples are the importance of raising HDL, increasing physical activity, decreasing obesity, and much more. The disadvantage of this study is that is is not necessarily representative of our entire population, since its participants all come from Framingham, Massachusetts. However, given the magnitude of the investment over many years and three generations, there is no other study in this area that can provide such a wealth of data.

Next