In the development of atherosclerosis, the following are significant risk factors:
Male gender
Being a male predisposes you to acquire atherosclerosis. This is one of the irreversible risk factors.
Family history of premature IHD (before age 55 in a parent or sibling)
If you do not have a family history of IHD. Meaning, your parents, brothers, or sisters did not experience IHD before the age of 55, then very likely you will not suffer from it. This is also one of the irreversible risk factors.
Hyperlipidemia
Hyperlipidemia refers to the elevation of cholesterol (hypercholesterolemia) and/or elevation of triglycerides (hypertriglyceridemia) in your blood. Men with cholesterol blood level of greater than 6 mmol/L (240 mg/dL) have more than a threefold increase in the risk of IHD death compared with men with cholesterol levels below about 5 mmol/L (200 mg/dL). As the cholesterol level in your blood increases, there is a corresponding increase in your risk of having IHD and an increase in cholesterol level is greatly associated with an increase in the low-density lipoproteins (LDL). Hypertriglyceridemia is also associated with the occurrences of IHD. This association further increases if there is a concomitant elevation of your cholesterol level. Increase in your triglycerides is associated with an increase in very low-density lipoproteins (VLDL).
Cigarette smoking (currently smoking more than 10 cigarettes per day)
Cigarette smoking is considered to be one of the most potent risk factors for atherosclerosis. However, when it is reduced or stopped, the risk of developing atherosclerosis is greatly reduced. Statistics show an increase of about 70 percent in the death rate and a three- to fivefold increase in the risk of IHD in men who smoke one pack of cigarettes per day, compared with nonsmokers.
Hypertension
Hypertension is a big risk factor for the development of atherosclerosis, and increases progressively as the level of your blood pressure increases. Based on the Framingham Study, the incidence of IHD among middle-aged men with blood pressures exceeding 160/95 was more than five times that in normotensive men (blood pressure 140/90 or less). It seems that hypertension aggravates atherosclerosis throughout the age span. Hypertension and atherosclerosis have a very interesting relationship. Although atherosclerosis starts and causes the development of hypertension, hypertension aggravates the status of any existing atherosclerosis. Thus, the worsening of any existing atherosclerotic process is hastened by the newly developed and existing hypertension.
Low HDL cholesterol [below 0.9 mmol/L (35 mg/dL )]
The HDL cholesterol is responsible for the so-called reverse cholesterol transport as mentioned in the preceding. It carries back to the liver for elimination around 20% of the total plasma cholesterol. Were it not for the HDL, much of your cholesterol could have been deposited in your peripheral tissues, aggravating any ongoing atherogenesis. It has been established that the higher your HDL is, the lower the possibility that you will suffer from IHD. The lower your HDL is, the higher the possibility you will experience IHD. Thus, the level of your HDL serves as an index of how well you are protected from IHD. Thus, the relationship of HDL level in your blood and the occurrences of IHD is inversely proportional.
Diabetes mellitus
In different studies, it has been shown that there is an association of hyperglycemia with the development of atherosclerosis. In a group of diabetics, whether insulin-dependent or non-insulin-dependent, there is at least a twofold increase in the incidence of myocardial infarction compared with nondiabetics. To negate this complication, your elevated sugar must at all times be controlled by the use of drugs and changes in lifestyle.
Hyperinsulinemia
Hyperinsulinemia is a medical condition where the concentration of insulin in your blood is very much higher than what is needed. This takes place because the organs which are normally reactive to insulin are no longer responsive. As a result, the pancreas keeps on pouring in insulin into the blood with the hope that your glucose levels will go down. Because your organs do not react to insulin, this medical condition is also called insulin resistance. The consequence of hyperinsulinemia, or insulin resistance, is sustained elevation of your blood glucose, which will lead to atherosclerosis.
Abdominal obesity
In general, the rate of morbidity and mortality arising from the occurrences of IHD increases as your body weight increases. If you are overweight by 30 percent, then you have a much higher risk of developing atherosclerosis. In addition, an elevated weight will worsen existing atherosclerosis that is caused by other conditions such as hypertension and IHD.
High lipoprotein (a)
The chemical structure of lipoprotein is similar to that of LDL, and as such, they behave in a similar manner. Lipoprotein is synthesized in the liver and its plasma concentration ranges from < 1 mg to > 1,000 mg/dL. If the level of lipoprotein is over 20-30 mg/dL, then a two-fold risk of developing coronary artery disease takes place. Sex and age have little influence on lipoprotein (a) levels. However, it is believed that direct deposition of lipoprotein on arterial wall is the possible mechanism wherein it causes CAD, considering that lipoprotein is more prone to oxidation than LDL. In addition, most prospective studies have confirmed that lipoprotein (a) is a predisposing factor for atherosclerosis.
Personal history of cerebrovascular disease or occlusive peripheral vascular disease
If any member of your family, parents or siblings, had a history of cerebrovascular disease or any occlusive peripheral vascular disease, then you need to consult a medical doctor for proper evaluation. It is possible that you have the risks for the said medical problem and preventive measures need to be implemented.
Physical inactivity
Various studies revealed that the less sedentary you are, the less that you will experience sudden death. This relationship follows from the fact that physical exercises prevent the occurrences of IHD.
Stress and personality
There are indications that psychic, emotional, and anxiety stresses could precipitate the occurrences of IHD. It is even theorized that there are individuals whose type of personality makes them more prone to suffer from IHD.
Genetic factors
Premature atherosclerosis seems to be linked to genetic factors. This means some individuals by nature are prone to develop atherosclerosis, much as how there are individuals who seemingly have the predisposition to develop hypertension, diabetes mellitus, and hyperlipidemia.