These Cardiovascular Disease Risk Factors May Surprise You
CARDIOVASCULAR DISEASES (SUCH AS HEART ATTACK OR STROKE) are the primary causes of disability and premature death, according to the World Health Organization. Today we look at some heart disease surprises. Newly recognized cardiovascular risk factors include the following:
- Rheumatoid arthritis
- Psoriasis
- Lupus
- Inflammatory bowel disease
- Gout.
This article will explore ten things you should know about cardiovascular risk factors. Then, we’ll turn to the new cardiovascular risk factors, including diseases characterized by systemic inflammation.
“Heart disease has changed my eating habits, but I still cook bacon for the smell.” — George Carlin.
Ten cardiovascular risk factors
Since 2020, the American Society for Preventative Cardiology (ASPC) has produced a top 10 cardiovascular risk factor list. Let’s get right to the 2022 list:
- Unhealthy diet.
2. Physical inactivity.
3. Dyslipidemia. Almost two in five adults in the United States have high cholesterol (total blood cholesterol ≥ 200 mg/dL). Too much cholesterol puts you at risk for heart disease and stroke, two leading causes of death in the United States.
4. Pre-diabetes or diabetes.
5. High blood pressure. Nearly half of the adults in the United States (47 percent, or 116 million) have hypertension. Million Hearts notes that high blood pressure is a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg (or you are taking medication for hypertension).
6. Obesity. More than two-thirds of US adults are overweight or obese. The prevalence of obesity (body mass index/BMI ≥ 30 kg/m2) is 42 percent. An additional 31 percent are overweight, with a body mass index of 25 to 30. In 2022, the level of overweight/obesity in the United Kingdom was 64 percent. Britain has one of the highest levels of obesity in Europe, as 28 percent of the population was classified as obese in 2019.
7. Thrombosis (blood clots).
8. Kidney dysfunction.
9. Genetics/familial high cholesterol.
10. Select populations (older age, race/ethnicity, sex).
These cardiovascular risk factors may surprise you.
According to an editorial in the American Journal of Medicine, multiple new risk factors for CVD have emerged over the past few years.
These newly identified risk factors include inflammatory diseases. These risk-raising conditions include gout, psoriasis, lupus, inflammatory bowel disease, and autoimmune collagen vascular diseases.
These diseases are all associated with an increased tendency to develop coronary artery disease. Each of the conditions increases the inflammasome.
Inflammasomes are cytosolic (one of a cell’s liquids) multiprotein oligomers (a molecule that consists of a few repeating units). Inflammasomes are part of the innate immune system responsible for activating inflammatory responses.
Gout and cardiovascular disease risk
Here are the findings from a 2022 study examining the relationship between gout and cardiovascular events:
Among individuals with gout, those who experienced a cardiovascular event, compared with those who did not experience such an event, had significantly higher odds of a recent gout flare in the preceding days. These findings suggest gout flares are associated with a transient increase in cardiovascular events [such as a heart attack or stroke] following the flare.
Rheumatoid disease and cardiovascular disease risk
We know that those with autoimmune rheumatic diseases are more likely to develop atherosclerotic cardiovascular disease. However, there is less information about such illnesses and premature cardiovascular disease.
Researchers used the Veterans With Premature Atherosclerosis (VITAL) registry, including patients with premature (males under 55, females less than 65) and extremely premature atherosclerotic cardiovascular disease. The US Veterans Affairs (VA) healthcare system collected the data.
The team assessed the age at the time of the first cardiovascular event for patients with premature (or extremely premature) cardiovascular disease. They compared these individuals with age-matched patients without atherosclerotic cardiovascular disease.
Rheumatoid arthritis is an autoimmune condition that can cause joint stiffness, pain, or swelling. RA has no cure, but early diagnosis and management can help with symptoms and decrease the chances of permanent joint damage.
Rheumatoid arthritis symptoms
Those with rheumatoid arthritis have times when the symptoms get worse (flares) or get better (remission). RA symptoms include the following:
- Pain, aching, or stiffness in two or more joints
- Swelling and tenderness in two or more joints
- The same symptoms on both sides of the body for example, in both hands or both knees)
- Fever
- Weight loss
- Fatigue or tiredness
- Weakness
It is common for rheumatoid arthritis symptoms in the hands, wrists, and knees. However, other tissues and organs, including the heart, lungs, and eyes, can be affected.
RA symptoms commonly affect joints in the hands, wrists, and knees but can also affect tissues and organs throughout the body, including the lungs, heart, and eyes. Rheumatoid symptoms can vary from mild to severe.
The Veterans With Premature Atherosclerosis (VITAL) study yielded this finding:
Rheumatoid arthritis was associated with a 1.7 times higher risk of premature atherosclerotic cardiovascular disease.
Other risk factors for cardiovascular disease
The Lupus Foundation of America offers this definition of lupus:
“Lupus is a chronic (long-term) disease that can cause inflammation and pain in any part of your body. It is an autoimmune disease, which means that your immune system — the body system that usually fights infections — attacks healthy tissue instead.”
Lupus most commonly affects the joints, skin, and internal organs (such as the heart and kidneys). The Mayo Clinic (USA) explains that symptoms may include the following:
- Fatigue
- Fever
- Joint pain, stiffness, and swelling
- Skin lesions that appear or worsen with sun exposure
- Fingers and toes that turn white or blue when exposed to cold or during stressful periods
- A butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body
- Shortness of breath
- Chest pain
- Dry eyes
- Headaches, confusion, and memory loss
We don’t know what causes lupus. Triggers may include sun exposure (bringing on skin lesions of setting off an internal response in susceptible individuals). Infections can also trigger lupus (or a relapse) in some individuals. Finally, some medicines (including for seizures, hypertension, or infection) can incite lupus.
Lupus is more common in women. African Americans, Hispanics, and Asian Americans have a higher risk, too. Finally, while the disease affects people of all ages, lupus is most often diagnosed in people between 15 and 45.
Please see your healthcare provider if you develop an unexplained rash, persistent itching, an ongoing fever, or unusual fatigue.
The VA study analysis yielded the following results:
Patients with systemic lupus erythematosus had a three times higher likelihood of extremely premature atherosclerotic cardiovascular disease.
Key points — Cardiovascular disease risk factors
Question. Do inflammatory diseases increase cardiovascular disease risk?
Findings. Newly recognized cardiovascular risk factors include the following 1) rheumatoid arthritis; 2) psoriasis; 3) lupus; 4) inflammatory bowel disease; and 5) gout.
Meaning. Patients with systemic lupus erythematosus and rheumatoid arthritis carry higher odds of premature and extremely premature atherosclerotic cardiovascular disease. Such patients need to eat a heart-healthy diet, not smoke, exercise regularly and maintain a healthy weight.
In addition, good management of diabetes, cholesterol, and blood pressure is optimal. Finally, get sufficient sleep, manage stress, limit alcohol, and see your health care provider regularly.
With healthy habits and healthcare professional guidance, you can significantly drop your odds of suffering from cardiovascular disease.
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