Risk Factors for Coronary Heart Disease
The majority of patients with CHD have identifiable risk factors. Epidemiologic studies have implicated a positive family history, male sex, lipid abnormalities, diabetes mellitus, hypertension, physical inactivity, short sleep duration, obesity, and smoking as risk factors. Many of these factors are modifiable; see Chapter 4 for a more detailed discussion on how to reduce risk. Markers of inflammation, particularly high-sensitivity C-reactive protein (CRP), may also represent strong risk factors for CHD.
CHD is the leading cause of death in women, accounting for one-third of all deaths, and kills more women than men each year. The average lifetime risk of CHD in women is very high, nearly 1 in 2. Compared with a man of the same age, a 50-year-old woman with a single additional risk factor has a substantially higher lifetime risk for CHD. Fortunately, most CHD risk in women is modifiable with the recommendations previously discussed; optimizing modifiable risk is of crucial importance in women.
In addition, postmenopausal women are disproportionately affected by a stress-induced cardiomyopathy called takotsubo cardiomyopathy, or broken-heart syndrome. This disorder may mimic an acute MI, but testing reveals no occlusive vascular disease. The etiology is unclear.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.