Overview of Coronary Artery Disease: Analysis of High-Risk Factors and Independent Risk Factors

Coronary heart disease (CHD) is short for coronary atherosclerotic heart disease, which refers to heart disease caused by narrowing or blockage of the coronary arteries due to atherosclerosis, leading to myocardial ischemia, hypoxia, or necrosis. CHD risk factors include: (1) Genetic factors: A clear familial tendency. (2) Age: Increases after age 40. Acute CHD events are increasingly occurring at younger ages, even as early as around age 30. (3) Gender: Higher incidence in men than women, with increased incidence in women after menopause. (4) Diet: High-fat, high-cholesterol diets. (5) Smoking: Nicotine and carbon monoxide exacerbate atherosclerosis and induce coronary artery spasm. (6) Excessive alcohol consumption: Inhibits lipoprotein lipase, causing triglyceride levels to rise. (7) Psychological factors: Strenuous exercise, excessive fatigue, and anger can induce plaque rupture. (8) Hypertension: Hypertensive patients are about four times more likely to develop CHD than those without hypertension. (9) Hyperlipidemia: An independent risk factor for stroke, CHD, and sudden cardiac death. (10) Overweight and obesity: Obese individuals have a higher incidence rate. (11) Diabetes: The incidence of coronary heart disease is 2 to 3 times higher than that of normal people. High postprandial blood glucose increases the risk of coronary heart disease. (12) Lack of exercise. (13) New risk factors: homocysteine, C-reactive protein, and fibrinogen. Homocysteine ​​is a sulfur-containing amino acid and an intermediate product of methionine metabolism in the human body. The normal content is 5 to 15 μmol/L. Excessive homocysteine ​​in the blood is an independent risk factor for arteriosclerosis, coronary heart disease, and stroke. Homocysteine ​​causes endothelial damage and disrupts coagulation factor II and fibrinolysis. Studies have shown that for every 5 mmol/L increase in homocysteine ​​in the blood, the risk of coronary heart disease increases by 33% and the risk of stroke increases by 59%; for every 3 mmol/L decrease in homocysteine, the risk of coronary heart disease decreases by 16% and the risk of stroke decreases by 24%. Hyperhomocysteinemia and hypertension are the two most important factors leading to stroke. Coronary artery disease (CAD) is classified into: asymptomatic or latent type, angina pectoris, myocardial infarction, ischemic cardiomyopathy, and sudden cardiac death. Latent CAD does not present with angina, but myocardial ischemia is evident on electrocardiogram (ECG) or when the cardiac workload is increased. Angina pectoris is mainly divided into stable and unstable types. Myocardial infarction (AMI) refers to acute ischemic necrosis of the myocardium. Sudden cardiac death refers to death within 1 hour or 24 hours of onset.