Slide 1Cardiovascular disease risk factorsCardiovascular disease risk factorsCardiovascular disease risk factorsCardiovascular disease risk factorsHow were risk factors identified?A little history…Slide 8Slide 9Slide 10Slide 11Slide 12Slide 13Framingham Heart Study TodaySlide 15Slide 16Slide 17Cardiovascular Disease (CVD) Risk FactorsPhysical ActivityUnit 2 Lecture 3Cardiovascular disease risk factorsWhat factors are associated with cardiovascular disease?Examine common characteristics that are present in a populationCriteria for a risk factor:1) statistical relationship2) potential mechanism to explain the relationshipCardiovascular disease risk factorsNon-modifiable1) Age2) Sex- men > premenopausal women - men ~ postmenopausal women - stroke risk: men ~ women3) Heredity (including race)- Family History- 2%: Familial hypercholesterolemia - LDL receptor mutation - High LDL and heart attack at young age - first degree relative CHD or stroke <55 (male) or <65 (female)Cardiovascular disease risk factors•Smoking•High blood cholesterol–< 200 mg/ dl = optimal –> 240 = high •High triglycerides–< 150 = optimal –> 200 mg/dl = high •High blood pressure<120/80 = normal120-139/80-89 = pre-hypertension140-159/90-99 = stage 1>169/>100 = stage 2ModifiableCardiovascular disease risk factors•Diabetes FPG < 100 mg/dl, 101-126 mg/dl = prediabetes 126 mg/dl = diabetes •Obesity•BMI: 18.5- 24.9= normal •25-29.9= overweight •> = obese•Physical inactivity/sedentary lifestyle•Unhealthy Diet•Fat intake•Fruit and vegetable consumption ModifiableHow were risk factors identified?•Objective: to identify the common factors or characteristics that contribute to CVDCVD endpointsCoronary Heart DiseaseStrokePeripheral Artery DiseaseCongestive Heart Failure•5209 participants, aged 30-62•No symptoms of CVD, no MI or stroke• ProspectiveA little history…1929-1940: Great Depression1939-1945: WWII1945: FDR Dies of a massive heart attack (BP was 300/190)Post war prosperityautomatic dishwasherelectric lawnmowerautomobile ownershiptelevision “great antidote to physical activity”changes in diet – fat and cholesterolsmoking increases1955: President Eisenhower has a heart attack.1961: First paper released from Framingham heart study3 major modifiable “risk factors” for heart disease: high blood pressure, high cholesterol, smokingNew concept of “risk factor”: Links between characteristics and future disease developmentFramingham Heart Study Today•Offspring cohort added 1971–5124 children & spouses•3rd Generation Cohort 2002–3500 grandchildren•> 1000 scientific papers•2010 – new genes underlying heart disease risk factors•Estimation equations and calculators to determine CVD risk from presence of risk
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