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Coronary risk profile of young soldiers with coronary heart disease
Insights
Heavy cigarette smoking is the primary factor driving higher coronary heart disease (CHD) mortality in young British soldiers compared to civilians. Despite physical fitness, excessive smoking significantly increases CHD risk in this demographic.
Area of Science:
- Cardiology
- Military Health
- Epidemiology
Background:
- Junior British Army ranks exhibit higher coronary heart disease (CHD) mortality rates than comparable British civilians.
- Investigating the specific risk factors contributing to this disparity is crucial for public health initiatives.
Purpose of the Study:
- To identify the key coronary risk factors differentiating young soldiers with CHD from their civilian counterparts.
- To explain the elevated CHD mortality observed in junior British Army personnel.
Main Methods:
- A retrospective study analyzing coronary risk factors in young soldiers diagnosed with CHD.
- Comparison of risk factor prevalence between affected soldiers and young civilian CHD patients.
Main Results:
- High prevalence of heavy cigarette smoking identified as the major discriminant factor.
- Young soldiers with CHD showed higher obesity rates and significantly greater daily cigarette consumption (24% smoking 40+ cigarettes/day) compared to civilians.
- Elevated cholesterol levels were noted in younger CHD patients, potentially linked to familial hypercholesterolaemia.
Conclusions:
- Heavy cigarette smoking is the predominant risk factor for CHD in young British soldiers, overwhelming the benefits of physical fitness.
- Reduced cigarette costs in certain military postings may contribute to increased smoking prevalence.
- Findings highlight the urgent need for targeted smoking cessation programs within the military.
Abstract:
In a retrospective study of coronary risk factors in young soldiers with coronary heart disease (CHD), designed to explain why junior ranks in the British Army have a higher mortality rate from CHD than comparable British civilians, high prevalence of heavy cigarette smoking was found to be the major discriminant. In general, young men with CHD have higher prevalence of cigarette smoking, and a higher per capita consumption than older men with CHD. They also have higher cholesterol levels, perhaps resulting from more symptomatic cases of familial hypercholesterolaemia in the younger age group. Young affected soldiers are more obese than young affected civilians and smoke more cigarettes (24% smoke 40 or more per day). This may be related to the reduced cost of cigarettes to soldiers in some parts of the world. In the British Army, the expected protective effect of physical fitness is overwhelmed by the deleterious effect of high cigarette consumption.