Potential new cardiovascular risk factors: left ventricular hypertrophy, homocysteine, lipoprotein(a), triglycerides,...

Area of Science:

• Cardiology
• Preventive Medicine
• Biochemistry

Background:

• The 1996 Bethesda Conference identified several potential new cardiac risk factors.
• These include left ventricular hypertrophy, hyperhomocysteinemia, lipoprotein(a) excess, hypertriglyceridemia, oxidative stress, and hyperfibrinogenemia.

Purpose of the Study:

• To review current literature supporting these conditions as cardiac risk factors.
• To assess the evidence for their role in cardiovascular disease and potential benefits of modification.

Main Methods:

• Literature review of studies on new cardiac risk factors.
• Analysis of evidence regarding left ventricular hypertrophy, homocysteine, lipoprotein(a), triglycerides, oxidative stress, and fibrinogen.

Main Results:

• Left ventricular hypertrophy is an independent vascular disease risk factor.
• Hypertriglyceridemia shows increasing evidence of an independent role in cardiovascular disease.
• Vitamin E supplementation shows benefit, while data for other antioxidants are weaker. Evidence for others is preliminary or controversial.

Conclusions:

• Routine clinical application of these new risk factors is premature.
• More evidence is needed to confirm their prognostic ability beyond conventional factors and the benefit of modification for reducing cardiovascular events.