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    • 2.

      Physical Inactivity

      • Regular physical activity (during the adult years) reduces risk of CAD.

      • Greater cardiovascular fitness (assessed by ergometer or treadmill testing), is associated with lower risk for CAD in middle – aged men and women.

      • Bouts of physical activity are associated with a transiently increased risk of MI, and greater incidence of SCD among reconditioned middle – aged persons.

      • The overall impact of regular exercise is cardioprotective among moderately active middle

        • aged persons.

      • Regular exercise is often accompanied by weight reduction, less smoking and increased HDL – C.

    • 3.

      HDL – Cholesterol

      • Levels of HDL – C typically do not vary greatly throughout adulthood, but mean cholesterol levels typically peak in men around the age of 55 years and in women at age 65 years.

      • Total cholesterol and low levels of HDL – C have been found together for the identification of persons at high risk of an initial MI

      • A variety of factors affect HDL – C:

          • a.

            Higher levels: Estrogen usealcohol intake – leanness

          • b.

            Lower levels: Androgen or progestin use – obesity – elevated TG

      • Medications that lower LDL – C may raise HDL – C particularly niacin and fibrates.

    • 4.


      • Obesity confers increased risk for CAD.

      • Central adiposity, using waist circumference divided by hip circumference (waist – hip ratio) is associated with increased CAD risk.

      • Obesity is associated with abnormal lipid, impaired glucose tolerance, elevated B.P., and physical inactivity.

      • Loss in weight, promotes favorable changes in several risk factors in the same time.

  • III.

    Nonmodifiable Risk Factors

Sex: Atherosclerosis is more common among men than women. The higher prevalence of atherosclerosis in men is thought to be due to the protective effects of the female sex hormones. This sex effect is absent after menopause in women. The incidence of coronary heart disease among women parallels that of men, but women demonstrate an approximately 10year chronological delay in the onset of clinical manifestations. Age: Most cases of atherosclerotic vascular disease become clinically apparent in patient aged 4070 years.

Family history: of premature coronary heart disease.


  • 1)

    All the following statements are correct except.

    • a.

      Cigarette smoking has been significantly linked to CAD.

    • b.

      Smoking cessation reverses this increased risk within few years.

    • c.

      Smoking adverse impact is dose dependant.

    • d.

      Smoking filtered cigarette and products low in tar and nicotine have less impact on CAD.


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