Cardiovascular disease risk factor
Cardiovascular disease risk factor
Age
Age is an important risk factor in developing cardiovascular
diseases. It is estimated that 82 percent of people who die of coronary
heart disease are 65 and older
. At the same time, the risk of stroke doubles every decade after age 55.
Multiple explanations have been proposed to explain why age increases
the risk of cardiovascular diseases. One of them is related to serum
cholesterol level.
In
most populations, the serum total cholesterol level increases as age
increases. In men, this increase levels off around age 45 to 50 years.
In women, the increase continues sharply until age 60 to 65 years.
Aging is also associated with changes in the mechanical and
structural properties of the vascular wall, which leads to the loss of
arterial elasticity and reduced arterial compliance and may subsequently
lead to coronary artery disease.
Gender
Men are at greater risk of heart disease than pre-menopausal women.
However, once past menopause, a woman’s risk is similar to a man’s.
Among middle-aged people, coronary heart disease is 2 to 5 times more common in men than in women.
In a study done by the World Health Organization, gender contributes to
approximately 40% of the variation in the sex ratios of coronary heart
disease mortality.
[11]Another
study reports similar results that gender difference explains nearly
half of the risk associated with cardiovascular diseases
One of the proposed explanations for the gender difference in cardiovascular disease is hormonal difference.
Among women, estrogen is the predominant sex hormone. Estrogen may have
protective effects through glucose metabolism and hemostatic system,
and it may have a direct effect on improving endothelial cell function.
The production of estrogen decreases after menopause, and may change
the female lipid metabolism toward a more atherogenic form by decreasing
the HDL cholesterol level and by increasing LDL and total cholesterol
levels.
Women who have experienced early menopause, either naturally or because
they have had a hysterectomy, are twice as likely to develop heart
disease as women of the same age group who have not yet gone through
menopause.
Among men and women, there are differences in body weight, height,
body fat distribution, heart rate, stroke volume, and arterial
compliance.
In the very elderly, age related large artery pulsatility and stiffness is more pronounced in women.
This may be caused by the smaller body size and arterial dimensions independent of menopause.
Air pollution
Particulate matter have been studied for their short- and long-term exposure effects on cardiovascular disease. Currently, PM
2.5 is the major focus, in which gradients are used to determine CVD risk. For every 10 μg/m
3 of PM
2.5 long-term exposure, there was an estimated 8-18% CVD mortality risk.
Women had a higher relative risk (RR) (1.42) for PM
2.5 induced coronary artery disease than men (0.90) did.
Overall, long-term PM exposure increased rate of atherosclerosis and
inflammation. In regards to short-term exposure (2 hrs), every 25 μg/m
3 of PM
2.5 resulted in a 48% increase of CVD mortality risk.
Additionally, after only 5 days of exposure, a rise in systolic (2.8
mmHg) and diastolic (2.7 mmHg) blood pressure occurred for every 10.5
μg/m
3 of PM
2.5.
Other research has implicated PM
2.5 in irregular heart rhythm, reduced heart rate variability (decreased vagal tone), and most notably heart failure.
PM
2.5 is also linked to carotid artery thickening and increased risk of acute myocardial infarction.
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