What all factors predispose to risk of vascular plaque formation (atherosclerosis) which may lead to heart attack, unstable angina, need for coronary bypass surgery or angioplasty, heart failure, stroke or sudden death?

Can one simply count the factors present in an individual to determine his/her risk or should one use formal scoring systems?


1 Answer 1


Following were independent risk factors found in the large Interheart study (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2804%2917018-9/abstract):

1. Smoking
2. Diabetes
3. High blood lipid levels
4. High blood pressure
5. Abdominal obesity
6. Psychosocial stress
7. Lack of regular physical exercise
8. Lack of regular fruits and vegetable intake

There was also evidence for a protective effect of regular alcohol intake but it was not protective after adjusting for all other risk factors (http://www.medscape.com/viewarticle/489738#vp_2 - Table shows confidence intervals overlap value of 1 indicating non-significance).

Though each of the above factors confer different degree of risk and for each factor, its severity (for example, number of cigarettes smoked) also affects the risk, a simple counting of the factors present would reflect a person's risk for atherosclerotic vascular diseases like heart attack, stroke and sudden death. Though formal scoring systems may be more accurate, they have the disadvantage of being complex, difficult to derive and tendency to become redundant when newer risk factors are found.

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