Risk factors for coronary heart disease.

Age: atherosclerosis develops progressively as age advances. It is rarely present in early childhood, except in familial hyperlipidaemia. It is almost universal in the elderly in the western world.

Sex: Men are more affected than premenopausal women. However, after the menopause the incidence of atheroma in women becomes similar to that in men.

Family history: Coronary artery disease is often found in several members of the same family. Because the disease is so prevalent and because other risk factors are familial, it is uncertain whether family history is an independent risk factor.

High cholesterol: Atherosclerotic plaques contain cholesterol. A high serum cholesterol is strongly associated with coronary atheroma. Lowering the serum cholesterol level has been shown to decrease the incidence of coronary artery disease and slow the progression of coronary atheroma.

Smoking: In men the risk of developing coronary artery disease is directly related to the number of cigarettes smoked. This relationship is less certain in women and in cigar and pipe smokers. The risk from smoking declines to almost normal after 10 years abstention.

Other factors: Lack of exercise increases the risk of coronary artery disease, and regular exercise probably protects against it's development.

Diabetes mellitus.

Obesity.

Gout, oral contraceptives, alcohol and soft water have also been suggested as risk factors for coronary artery disease.

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