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Risk factors for coronary heart disease in patients below 45 years of age
Mansoor Nadeem1, Syed Shahzad Ahmed2, Sarah Mansoor3
1Mansoor Nadeem, MBBS, MCPS, FCPS, Associate Professor, Department of Medicine, POF Hospital, Wah Medical College, Wah Cantonment, Punjab, Pakistan.
Insights
Established coronary artery disease (CAD) in younger patients is strongly linked to family history, smoking, hypertension, dyslipidemia, and diabetes. Increased BMI and abdominal girth are also significant risk factors requiring national-level assessment.
Area of Science:
- Cardiology
- Public Health
Background:
- Coronary artery disease (CAD) traditionally affects older populations.
- There is a growing concern regarding the incidence of early-onset CAD.
Purpose of the Study:
- To identify and analyze traditional risk factors and biochemical profiles in patients with established CAD.
- To compare these trends across different age groups and populations.
Main Methods:
- Inclusion of consecutive patients under 45 with confirmed ischemic heart disease and ECG changes.
- Exclusion of patients with doubtful history or non-classical ECG findings.
- Data collection included family history, risk factors, clinical examination, and biochemical tests (total cholesterol, HDL cholesterol).
Main Results:
- Common risk factors identified: cigarette smoking (46%), family history (43%), hypertension (37%), dyslipidemia (33%), diabetes mellitus (18%), and elevated BMI (63.3%).
- Increased abdominal girth emerged as a significant risk factor, sometimes independent of obesity.
- Smoking was less prevalent in females compared to males.
Conclusions:
- Key risk factors for established CAD include family history, smoking, hypertension, elevated BMI, increased abdominal girth, dyslipidemia, and diabetes mellitus.
- Given the rising incidence of coronary heart disease, a national-level assessment and evaluation of these risk factors are crucial.
Objective:
To examine the traditional risk factors and biochemical profile of patients with established CAD (coronary artery disease), and compare the trends of these in specified age groups of different populations as depicted in various studies.
Methodology:
All consecutive patients below 45 years of age, having classical history of Ischemic heart disease and also having definite ECG changes consistent with coronary artery disease were enrolled. These patients were admitted to CCU/Intermediate Coronary Care Unit of Pakistan Ordinance Factories (POF) Hospital Wah Cantonment from April 2007 to December 2011. Patients who had doubtful history as regards CHD and those having ECG changes not classically consistent with CAD were excluded. Information collected through Performa included history including family history and details of risk factors. Clinical examination was carried out and relevant investigations including the serial ECG changes were recorded. Blood samples were collected after an overnight fast of 14 hours and tests were done for total cholesterol and HDL cholesterol by using Pioneer-USA, linear chemical kits by cholesterol oxidase and enzymatic calometric method.
Results:
A total of 109 cases were included. Cigarette smoking (46%) Family history (43%), Hypertension (37%), Dyslipidemia (33%), Diabetes mellitus (18%) and above normal BMI (63.3%) are the most common risk factors in our patients. Increased abdominal girth has appeared to be an important risk factor and at occasions is documented to be independent of obesity. Casual dietary habits and sedentary life style are the other less important risk factors. The majority of risk factors were equally prevalent in males as well as females except smoking which was less prevalent in females.
Conclusions:
Our study shows that Family history, Smoking, Hypertension, increased BMI, increased Abdominal girth, Dyslipidemia and Diabetes Mellitus are the main risk factors. Considering the increasing incidence of the coronary heart disease in our society it is essential to assess and evaluate these risk factors at national level.
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