Explain Personal Risk Factors in CAD?
The personal risk factors are the factors that are specific and characteristic for a particular individual and are non-modifiable in nature, gender, and family history are the variables in the personal segment.
Age : Age is a risk factor in the sense that the atherosclerotic process, which starts early in life, progresses over the years as a function of time. The total plaque burden and incidence of coronary artery disease (and also of stroke) increases with age, becoming more prevalent in the elderly age groups. In men aged 30-39 years, ninety-eight per cent have the 10-year risk of CAD less than 10 per cent. But this rises to more than 20 per cent risk in 10 years in almost half of the men in the age group of 70-79 years. Similarly in women, while none have: 10 year- risk of 10 per cent iii the age group below 40, about 22 per cent will have a risk of 10 per cent or more in the age group 70-79 years.
Gender : In every age group, men suffer- more than women from atherosclerosis and coronary artery disease; women are to a great extent protected by the female sex hormones. However, this advantage, almost prominent in reproductive years, diminishes after menopause and women at six111 :und seventh decades have almost the same incidence as their male counterparts, The recent trend in the increasing incidence of CAD even in premenopausal years may be related to the stressful ire situations, rise in smoking habits and use of oral contraceptives in women. The mortality is also high among women alter a heart attack. Middle-aged women who have heart attacks are more likely than men to die within two years. US Physicians studying medical records of 6800 people treated for heart attacks in hospitals in Worcester, Massachusetts, between 1975 and 1995, found that women under 60 were almost 40 per cent more likely to die of their own age. The comparative risk for death was highest for younger women, and those under 50 had nearly 50 per cent more risk of' dying than their male counterparts. It is only among the very elderly heart attack patients that women have lower mortality rates. Again, after coronary bypass surgery, women have as much as three times higher risk of dying during or shortly after the surgery, even though their coronary atherosclerosis may be less extensive and their heart pumping action may be better; as reported by a US study.
Family History : History of corollary artery disease in close relatives like parents siblings indicates the hereditary predisposition to the coronary disease. Family history of CAD or other atherosclerotic vesicular disease at the early age in men11< 55 years, in women < 65 years) in first degree relatives like parents and siblings increases the risk of CAD. Sibling CVD appears to confer more risk than parental:~l premature CVD and represents a more useful marker of familial vulnerability lo C'VD events.
The true nature of the genetic susceptibility has not yet been fully understood, But it may be related to the aggregation of the major risk factors like diabetes, Hypertension, lipid abnormalities or obesity. Children born to familiar with a high prevalence of these risk factors re also a1 risk for development of CAI).