Year: 1995
Type: review
Abstract: Epidemiologic investigation of coronary heart disease (CHD) continues to yield additional important risk factors.CHD is best conceptualized as a multifactorial process, with no individual factor strictly essential or sufficient for causation.Invariably the hazard posed by any particular risk factor is markedly influenced by other risk factors that are often present.107Multivariate risk assessment is required to ascertain the joint effect of risk factors, and use of a set of risk factors provides a substantially better risk estimate than any single factor.Multivariate analyses help attain a better understanding of the pathogenesis of the disease and guidelines for prevention.Based on the absolute, relative, and attributable risks imposed by the various risk factors, concepts of normal have evolved from usual or average to more optimal values associated with long-term freedom from disease.Acceptable blood pressures, blood glucose levels, and lipid values have as a consequence been revised downward.23 , 49 Decades of epidemiologic research at Framingham and elsewhere have quantified the effect of cardiovascular risk factors that strongly contribute to coronary disease.107There are noteworthy differences in their impact on the various atherosclerotic cardiovascular sequelae.67 All of the major cardiovascular risk factors identified, however, contribute powerfully to coronary disease.These various risk factors promote coronary disease in either sex at all ages but with different strengths.Diabetes and low high-density lipoprotein (HDL) cholesterol operate with greater power in women.56, 57 Cigarette smoking is particularly influential in men, is noncumulative, and loses its adverse impact shortly after quitting.B2 Fibrinogen levels, elevated leukocyte count, homocysti-
Source: Medical Clinics of North America
Authors: William B. Kannel, Peter W.F. Wilson
Institutions: Boston University, Framingham Heart Study
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,350
Awards: G1965009114, G406965642
OpenAlex ID: W2316856729