Prevalence of Conventional Risk Factors in Patients With Coronary Heart Disease

Abstract

PPRECIATION OF THE CRUcial role of risk factors in the development of coronary heart disease (CHD) is one of the most significant advances in the understanding of this important disease. Extensive epidemiological research has established cigarette smoking, 1 diabetes, 2 hyperlipidemia, 3 and hypertension 4 as independent risk factors for CHD. In addition, treatment of these risk factors has been convincingly shown to reduce the risk of future cardiac events. 1,5 Because of the strength of evidence supporting their role in the pathogenesis of CHD, these 4 risk factors have often been labeled as "conventional" risk factors. Although the importance of conventional risk factors is well established, it is commonly suggested that more than 50% of patients with CHD lack any of the conventional risk factors. 6-13 This implies that other factors play a significant role in the development of this disease and, furthermore, that there is a substantial void in current understanding of the pathogenesis of CHD. This perceived void has led to considerable research on nontraditional risk factors and genetic causes of heart disease. Yet, data to support this "50%" belief are limited, and some have suggested that conventional risk factors play a much more significant role. 14,15 Determining the validity of this idea is important for scientific accuracy and to guide the practice of clinical medicine, public health policies, and prioritization of research efforts. In addition, patients and physicians can better understand the impact of preventing or modifying these specific risk factors on the risk of future CHD. We therefore sought to determine the prevalence of the 4 conventional risk

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