Clinical Assignment: Cardiovascular Risk Factors

Introduction
The American Heart Association has identified several risk factors that greater your chance of developing coronary heart disease and heart attack. Major risk factors are those that research has shown significantly increase the risk of heart and blood vessel (cardiovascular) disease. Risk factors are divided up into modifiable and non-modifiable as outlined below.
Patient Profile My patient on 03/31/2011 was M.M., who is a 55 year old Caucasian male who presented to UMC on 03/26/2011 with a chief complaint of shortness of breath, light headed, and pain in the left ankle. I choose M.M. as he had an admitting diagnosis of COPD exacerbation, syncope, and a medical history for being hospitalized with congestive heart failure (CHF), obstructive sleep apnea and COPD, and is currently a smoker.
Risk Factors
Age:
According to the American Heart Association (AHA), over 82% of people who die of coronary heart disease are 65 or older. Age is the most important risk factor for developing CAD in women. When compared with men, women are, on average, 10 years older when they have CAD. (Ignatavicius & Workman, 2010). At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks.
M.M. is 55 years old, so this risk factor does not directly apply to him right now.
Sex:
According to the AHA, men have a greater risk of heart attack than women do, and they have heart attacks earlier in life. Even after menopause, when women’s death rate from heart disease increases, it is not as great as men’s.
Being that M.M. is a male, this risk factor is applicable to this patient.
Family History:
Children of parents with heart disease are more likely to develop it themselves. Most people with a strong family history of heart disease have one or more risk factors. Since you cannot control your family history, this is considered a non-modifiable risk factor, which makes it even more important to pay attention and treat the modifiable risk factors.
I was unable to ask M.M. about his family history due to him being discharged, so it is unclear as to whether this risk factor directly relates to him.
Smoking:
According to Ignatavicius, tobacco use, especially cigarette smoking, accounts for over one third of deaths from CAD. The smoker’s risk of developing coronary heart disease is 2-4 times greater than that of nonsmokers. Cigarette smoking is a powerful independent risk factor for sudden cardiac death in patients with coronary heart disease. Cigarette smoking also acts with other risk factors to greatly increase the risk for coronary heart disease. “People who smoke cigars or pipes seem to have a higher risk of death from coronary heart disease, but their risk still is not as great as the cigarette smoker” (AHA, 2011).
M.M. is a 20 year cigarette smoker, who has averaged two packs a day until recently cutting down to less than a pack a day and has the desire to quit. I talked to him about using the patch, nicotine gum and other smoking cessation programs available.
High blood Pressure:
High blood pressure increases the hearts’ workload, causing the heart to thicken and become stiffer. Since the stiffening of the heart muscle is not normal, it causes the heart to have to work harder, which increases the risk of MI. It also increases your risk of stroke, kidney failure and congestive heart failure (Ignatavicius et al., 2010).
On admission, this patient’s blood pressure was 123/81 and was not hypertensive. There was no mention of a history of hypertension in his chart, but it was noted that he was on a cardiac prudent diet.
Obesity:
Obesity is strongly associated with the development of hypertension, diabetes and increased serum lipid levels (Ignatavicius et al., 2010). According to the AHA, people who have excess body fat — especially if a lot of it is at the waist — are