Question

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Joe, a 65-year-old man, is at a high risk for heart disease. He has several risk factors: old age, type 1 diabetes, high blood pressure, smoker, family history of heart disease, overweight, inactive, and has low HDL cholesterol and high LDL cholesterol levels. Therefore, Joe thinks that heart disease is inevitable and there’s nothing he can do. Of his listed risk factors, which ones does he actually have control overand what actions can he take to possibly change his fate?

Answer 1

Modifiable major risk factors are elevated serum lipids, hypertension, physical inactivity tobacco use, and obesity.

Elevated serum lipids: An elevated serum lipid level is one of the four most firmly established risk factors for heart disease The current national guidelines for treating elevated elevated LDL cholesterol are based on a person's 10year risk for having a non-fatal MI or dying from a coronary event and his or LDL levels. Risk sources are calculated based on information about the following: age, gender, use of tobacco, systolic BP, use of BP medications, total cholesterol and HDL cholesterol level.

Hypertension -is defined as the second major risk factor in CAD. The cause of hypertension in 90% of those affected is unknown, but it is usually controllable with diet or with drugs. Therapeutic lifestyle changes should begin in people with pre hypertension. Those with stage 1or 2 hypertension often require more than one drug to reach therapeutic goals.

The benefits of smoking cessation are dramatic and almost immediate. CAD mortality rate drops to those of non smokersvwithin 12 months. However, nicotine is highly addictive and often calls for intensive intervention to assist people to quit.

Physical Inactivity

It is a fourth major modifiable risk factor. Physical inactivity implies a lack of adequate physical exercise on regular basis. The current recommendation for health promoting regular physical activity is defined as a brisk walking that occurs at least 5 or more times a week for atleast 30minutes, causing perspiration and an increase in HR by 30 to 50beats/min.

Obesity is defined as a body mass index of >30kg/m2.The increased risk of heart disease is proportional to the degree of obesity Obese persons are thought to produce increased levels of LDL and triglycerides, which are strongly implicated in atherosclerosis. There is also evidence that individuals who tend to store fst in the abdomen rather than in the hips and buttocks have a higher incidence of CAD.