Coronary Heart Disease Risk Factors - Part II
Summary

There are many risk factors for CHD. In parts I and II of this CHD risk factor summary (and in other summaries at this site), we have reviewed many of the risk factors. Here is a list of the most common ones:

• High ratio of total-cholesterol to HDL

• Advancing age

• Type 2 diabetes mellitus

• Hypertension

• Obesity

• Cigarette smoking

• Family history of CAD

• High homocysteine

• Certain markers of inflammation, including C-Reactive Protein (CRP)

If we consider all (or even most) of these factors, we have a large (of the order of a factor of 10!) ratio between people with the highest risk, and people with the lowest risk. The Framingham calculator provides a framework for calculating your personal risk. Factors that are not included in it (e.g., homocysteine, CRP and possibly stress) can provide minor adjustments to the risk result.

The following is my opinion as a scientist:
This may be "as good as it gets". The process of the sudden dislocation of a piece of plaque that causes a heart attack could very well be a "chaotic process" meaning that it may occur in very different ways resulting from very slightly different starting points. This would imply that beyond the current risk analysis, we really cannot have a realistic expectation of identifying in advance the individuals who will actually become ill with CHD. This puts the responsibility for our health squarely back on our shoulders. We need to eat foods that have been shown to reduce CHD, lose weight, quit smoking, exercise, reduce stress, and worry less.

Easier said than done! But if we don't start trying, we won't get there (and I mean that literally!).

The impact of stress on CHD is presented in our stress review.

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