177 Cardiovascular Risk Factors,Classified in 10 Categories,to be Considered in the Prevention of Cardiovascular Diseases: An Update of the Original 1982 Article Containing 96 Risk Factors

Abstract

The first comprehensive listing of cardiovascular risk factors was presented in this journal in 1982 in the article, “96 Cardiovascular Risk Factors” (by Y. Omura & S. Heller), which was the most extensive list of cardiovascular risk factors written on the subject at that time. Since then, much research has been carried out to identify cardiovascular risk factors; according to the authors’ most recent computer search, close to 9,000 articles appeared between 1982 and 1996. Upon initial review of most of the abstracts of these articles, we were surprised to find that the number of cardiovascular risk factors has increased significantly (79 new factors in addition to those we published in 1982). With a few exceptions (7 risk factors are now considered to be questionable), those we listed in 1982 are still valid today, and have been further confirmed with additional data and improved technology. Through reviewing the abstracts of these articles, we found about 177 cardiovascular risk factors, including most of the 96 previously listed. Of the original 96, we have identified those now considered to be questionable, e.g. taking oral contraceptives, which today contain significantly lower doses of estrogen than in the past and are therefore much safer. All 177 cardiovascular risk factors are classified into the following 10 major categories, with the 11th category listing those factors now considered to be questionable:

1) Nutrition-Related Cardiovascular Risk Factors (33 risk factors)

2) Internal Cardiovascular Risk Factors Identifiable by Laboratory Tests: Abnormal Blood & Tissue Chemistry Findings Related to Cardiovascular Diseases (35 risk factors)

3) Drug, Chemical, Hormonal, and Nutritional Supplement Intake (Including Drug-Drug Interaction and Drug-Food Interaction) As Cardiovascular Risk Factors (34 risk factors)

4) Signs and Symptoms Associated With a High Incidence of Cardiovascular Diseases (33 risk factors)

5) Non-Invasively Detectable Abnormal Laboratory Findings Associated With Cardiovascular Diseases (13 risk factors)

6) Hereditary Cardiovascular Risk Factors (5 risk factors)

7) Environmental Cardiovascular Risk Factors, Including Air Pollution, Electromagnetic Fields, Materials that Contact the Body Surface, Poisonous Venoms, and Insertion of Needle into Infected Body Tissue by Acupuncture or Injection (14 risk factors)

8) Socioeconomic and Demographic Cardiovascular Risk Factors (7 risk factors)

9) Cardiovascular Risk Factors Related to Medical Care (2 risk factors)

10) Co-existence of Multiple Cardiovascular Risk Factors (1 risk factor)

11) Factors Previously Regarded As Cardiovascular Risk Factors, But Now in Question (7 risk factors)

While a few factors, like hereditary characteristics, age, and sex, generally cannot be changed, most of the cardiovascular risk factors can be controlled by changing one's lifestyle, maintaining proper dietary intake, and correcting any existing abnormalities once each individual's unique constellation of cardiovascular risk factors is recognized. Some factors can be recognized by individuals themselves, but many other factors require physical examinations and laboratory tests by a physician or properly trained paramedical to be recognized. Medical examinations and blood chemistry and other laboratory tests may be necessary to establish baselines and measure changes over time. Once abnormal parameters are identified, periodic examinations should follow with proper corrective measures monitored by a qualified medical professional.