Obesity, stress, and smoking: their role as cardiovascular risk factors in women

Obesity, defined as an increase of 20% or more above desired weight, has been found to be an independent, albeit weak, risk factor for coronary heart disease in women and may increase the relative risk of other factors such as hypertension, diabetes mellitus, and elevated total serum cholesterol and low-density lipoprotein-cholesterol. Type A personality and stress, on the other hand, appear to be moderate risk factors for coronary heart disease in women as well as in men. Approximately twice as many cardiovascular events occurred in type A women 35 to 64 years old as in type B women of the same age group. As expected, cigarette smoking is a major risk factor, primarily in young women. Women with smoking patterns similar to those of men experience similar rates of cardiovascular morbidity and mortality. In addition, smoking apparently acts synergistically with oral contraceptives and elevated total serum cholesterol to further increase risk.