The Newer Coronary Risk Factors

  • Peter W. F. Wilson


Although the traditional coronary risk factors have included blood pressure, cholesterol, and cigarette smoking, several other factors are now being considered. This chapter provides a sampling of some of these “newer” risk factors, particularly those that have a biologic basis. The major categories to be considered are hematologic, newer lipid particles and their metabolic considerations, vitamins and homocysteine, and aspects of glucose metabolism.


Coronary Heart Disease Risk Coronary Risk Factor Relative Odds Hemostatic Factor Angina PECTORIS 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Danesh J, Collins R, Appleby P, Peto R: Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA 1998, 279: 1477–1482.Google Scholar
  2. 2.
    Meade TW, Brozovic M, Chakrabarti RR, et al.: Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet 1986, 2: 533–537.PubMedCrossRefGoogle Scholar
  3. 3.
    Ridker PM, Vaughn DE, Stampfer MJ, et al.: Endogenous tissue-type plasminogen activator and risk of myocardial infarction. Lancet 1993, 341: 1165–1168.PubMedCrossRefGoogle Scholar
  4. 4.
    Thompson SG, Kienast J, Pyke SDM, et al.: Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. N Engl J Med 1995; 332: 635–641.PubMedCrossRefGoogle Scholar
  5. 5.
    Gebara OCE, Mittleman MA, Sutherland P, et al.: Association between increased estrogen status and increased fibrinolytic potential in the Framingham Offspring Study. Circulation 1995, 91: 1952–1958.PubMedCrossRefGoogle Scholar
  6. 6.
    Juhan-Vague I, Alessi MC: Plasminogen activator inhibitor 1 and atherothrombosis. Thromb Haemost 1993, 70: 138–143.PubMedGoogle Scholar
  7. 7.
    Willich SN, Levy D, Rocco MB, et al.: Circadian variation in the incidence of sudden cardiac death in the Framingham Heart Study population. Am J Cardiol 1987, 60: 801–806.PubMedCrossRefGoogle Scholar
  8. 8.
    Muller JE, Tofler GH, Stone PH: Circadian variation and triggers of onset of acute cardiovascular disease. Circulation 1989, 79: 733–743.PubMedCrossRefGoogle Scholar
  9. 9.
    Schaefer EJ, Lamon-Fava S, Jenner JL, et al.: Lipoprotein(a) levels and risk of coronary heart disease in men: the Lipid Research Clinics Coronary Primary Prevention Trial. JAMA 1994, 271: 999–1003.PubMedCrossRefGoogle Scholar
  10. 10.
    Ridker PM, Stampfer MJ, Hennekens CH: Plasma concentration of lipoprotein(a) and the risk of future stroke. JAMA 1995, 273: 1269–1273.PubMedCrossRefGoogle Scholar
  11. 11.
    Ridker PM, Cushman M, Stampfer MJ, et al.: Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997, 336: 973–979.PubMedCrossRefGoogle Scholar
  12. 12.
    Ridker PM, Rifai N, Pfeffer MA, et al.: Long-term effects of pravastatin on plasma concentration of C- reactive protein. The Cholesterol and Recurrent Events (CARE) Investigators. Circulation 1999, 100: 230–235.PubMedCrossRefGoogle Scholar
  13. 13.
    Steering Committee of the Physicians’ Health Study Research Group. Final report of the aspirin component of the ongoing Physician’s’ Health Study. N Engl J Med 1989, 321: 129–135.CrossRefGoogle Scholar
  14. 14.
    Peto R, Gray R, Collins R, et al.: Randomized trial of prophylactic daily aspirin in British male doctors. Br Med J 1988, 296: 313–316.CrossRefGoogle Scholar
  15. 15.
    Smith SC, Jr., Blair SN, Criqui MH, et al.: Consensus Panel Statement: Preventing heart attack and death in patients with coronary disease. Circulation 1995, 92: 2–4.PubMedCrossRefGoogle Scholar
  16. 16.
    Hennekens CH, Dyken ML, Fuster V: Aspirin as a therapeutic agent in cardiovascular disease: a statement for healthcare professionals • from the American Heart Association. Circulation 1997, 96: 2751–2753.PubMedCrossRefGoogle Scholar
  17. 17.
    CAPRIE Steering Committee: A randomized, blinded, trial of clopidogrel versus aspirin in patients at risk of ischemic events (CAPRIE). Lancet 1996, 348: 1329–1339.CrossRefGoogle Scholar
  18. 18.
    Austin MA, Breslow JL, Hennekens CH, et al.: Low density lipoprotein subclass patterns and risk of myocardial infarction. JAMA 1988, 260: 1917–1921.PubMedCrossRefGoogle Scholar
  19. 19.
    Gardner CD, Fortmann SP, Krauss RM: Association of small low-density lipoprotein particles with the incidence of coronary artery disease in men and women. JAMA 1996, 276: 875–881.PubMedCrossRefGoogle Scholar
  20. 20.
    Jeppesen J, Hein HO, Suadicani P, Gyntelberg F: Triglyceride concentration and ischemic heart disease: an eight-year follow-up in the Copenhagen Male Study. Circulation 1998, 97: 1029–1036.PubMedCrossRefGoogle Scholar
  21. 21.
    Wilson PWF, Myers RH, Larson MG, et al.: Apolipoprotein E alleles, dyslipidemia, and coronary heart disease: The Framingham Offspring Study. JAMA 1994, 272: 1666–1671.Google Scholar
  22. 22.
    Wilson PWF, Schaefer EJ, Larson MG, Ordovas JM: Apolipoprotein E alleles and risk of coronary disease: a meta-analysis. Arterioscler Thromb Vasc Biol 1996, 16: 1250–1255.CrossRefGoogle Scholar
  23. 23.
    Gofman JW, Young W, Tandy R: Ischemic heart disease arthrosclerosis, and longevity. Circulation 1966, 34: 679–697.PubMedCrossRefGoogle Scholar
  24. 24.
    Buring JE, O’Connor GT, Goldhaber SZ, et al.: Decreased HDL2 and HDL3 cholesterol, Apo A-I and Apo A-II, and increased risk of myocardial infarction. Circulation 1992, 85: 22–29.PubMedCrossRefGoogle Scholar
  25. 25.
    Stampfer MJ, Hennekens CH, Manson JE, et al.: Vitamin E consumption and risk of coronary heart disease in women. N Engl J Med 1993, 328: 1444 1449.Google Scholar
  26. 26.
    Rimm EB, Stampfer MJ, Ascherio A: Vitamin E consumption and risk of coronary heart disease in men. N Engl J Med 1993, 328: 1450–1456.Google Scholar
  27. 27.
    Steinberg D: A critical look at the evidence for the oxidation of LDL in atherogenesis. Atherosclerosis 1997, 131(Suppl)S5–S7.PubMedCrossRefGoogle Scholar
  28. 28.
    Alpha-tocopherol, Beta Carotene Cancer Prevention Study Group: The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994, 330: 1029–1035.Google Scholar
  29. 29.
    Boushey CJ, Beresford SAS, Omenn GS, Motulsky AG: A quantitative assessment of plasma homocysteine as a risk factor for vascular disease: probable benefits of increasing folic acid intakes. JAMA 1995, 274: 1049–1057.PubMedCrossRefGoogle Scholar
  30. 30.
    Selhub J, Jacques PF, Bostom AG, et al.: Association between plasma homocysteine and extracranial carotid stenosis. N Engl J Med 1995, 332: 286–291.PubMedCrossRefGoogle Scholar
  31. 31.
    Selhub J, Jacques PF, Wilson PWF, et al.: Vitamin status and intake as primary determinants of homocysteinemia in the elderly. JAMA 1993, 270: 2693–2698.PubMedCrossRefGoogle Scholar
  32. 32.
    Jacques PF, Selhub J, Bostom AG et al.: The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med 1999, 340: 1449–1454.PubMedCrossRefGoogle Scholar
  33. 33.
    Pyorala K: Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: results from two population studies in Finland. Diabetes Care 1979, 2: 131–141.PubMedCrossRefGoogle Scholar
  34. 34.
    Meigs JB, D’Agostino RB, Wilson PWF et al.: Risk variable clustering in the insulin resistance syndrome. Diabetes 1997, 46: 1594–1600.PubMedCrossRefGoogle Scholar
  35. 35.
    Kuusisto J, Mykkanen L, Pyorala K, Laakso M: NIDDM and its metabolic control predict coronary heart disease in elderly subjects. Diabetes 1994, 43: 960–967.PubMedCrossRefGoogle Scholar
  36. 36.
    UK Prospective Diabetes Study (UKPDS) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998, 352: 837–853.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Peter W. F. Wilson

There are no affiliations available

Personalised recommendations