Cardiovascular Risk Factors and Modifiers

Traditional Modifiable Risk Factors

Hypertension is a major risk factor that accelerates atherosclerosis, causes vascular remodeling, and contributes to left ventricular hypertrophy, significantly increasing the risk of poor outcomes in cardiovascular disease, according to the American Heart Association 1, 2
Dyslipidemia/Hypercholesterolemia, characterized by elevated LDL cholesterol and low HDL cholesterol, contributes to endothelial dysfunction and atherosclerosis, with approximately 63.2% of adults with hypertension also having hypercholesterolemia, as reported by the American College of Cardiology 1, 3
Diabetes Mellitus is associated with a 2.37-fold increased risk of myocardial infarction and significantly higher mortality rates in patients with acute coronary syndrome, according to the European Association for the Study of Diabetes 1
Current Cigarette Smoking causes endothelial dysfunction, promotes atherosclerosis, increases platelet aggregation, and induces coronary vasospasm, with a population attributable risk of 35.7% for myocardial infarction, as stated by the American Heart Association 1, 4

Increased Age is a strong independent risk factor for cardiovascular disease, with risk increasing substantially after age 65, according to the American College of Cardiology 1, 5, 6
Male Sex is associated with higher cardiovascular risk compared to pre-menopausal women of the same age, as reported by the European Society of Cardiology 1, 7
Family History of Premature CAD, particularly sibling history of premature coronary artery disease, carries stronger risk than parental history, according to the American Heart Association 8, 9, 6

Psychosocial Stress is associated with a 2.67-fold increased risk of myocardial infarction with a population attributable risk of 32.5%, as stated by the American Psychological Association 1
Auto-immune Inflammatory Diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and psoriasis, increase cardiovascular risk, according to the European League Against Rheumatism 9
HIV Infection is associated with increased cardiovascular risk through multiple mechanisms, as reported by the European AIDS Clinical Society 9

Elevated Coronary Artery Calcium Score, indicated by a CAC score >100 Agatston units or ≥75th percentile for age, sex, and ethnicity, indicates increased cardiovascular risk, according to the European Society of Cardiology 9
Arterial Stiffness, characterized by increased pulse wave velocity (>10 m/s carotid-femoral or >14 m/s brachial-ankle), is associated with increased cardiovascular risk, as stated by the American Heart Association 9

The presence of multiple cardiovascular risk factors results in high absolute risks for coronary heart disease and stroke, with 41.7% of US adults with hypertension having a 10-year CHD risk >20%, according to the American College of Cardiology 1
Risk assessment tools like SCORE2/SCORE2-OP or TIMI risk score can help quantify cardiovascular risk and guide management decisions, as reported by the European Society of Cardiology 9, 5, 6