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Risk Factors for Cardiovascular Disease

Service coordinators play critical roles in facilitating team consideration of consumers’ risk factors, and in developing plans that mitigate identified risks. The risk of heart disease posed by heredity, lifestyle, and history of heart disease, affect us all, including people with developmental disabilities. Confounding these common risk elements, some consumers with developmental disabilities have congenital heart disease. Consumers with Down syndrome or other chromosomal anomalies, such as Turner’s syndrome, have a high incidence of congenital heart defects. For example, approximately 57% of persons with Down syndrome have congenital heart problems.

There are many potential risks to be assessed and considered by teams and service coordinators. Familiarity with the risk factors outlined below should prove useful in supporting the heart health of consumers.

Risk Factors that can be Prevented, Controlled, or Treated

  • Smoking. Nicotine and carbon monoxide in tobacco smoke reduce oxygen in the bloodstream. Smoking lowers the HDL (beneficial) cholesterol and increases the clotting tendency of blood. People who smoke have a risk of cardiovascular disease that is 2-4 times greater than that of people who do not smoke. Smokers risk sudden death twice as much as their non-smoking peers. People who smoke risk developing peripheral vascular disease (narrowing of blood vessels to legs, arms, stomach, or kidneys) at a rate that is 10 times higher than that of people who do not smoke. Women over the age of 35 who smoke and use certain contraceptives greatly increase their risk of stroke.
  • High Cholesterol. As blood cholesterol levels rise, so do the risks of coronary heart disease and stroke. Couple that with other risk factors such as high blood pressure and/or smoking, the risk becomes even more significant.
  • High Blood Pressure. High blood pressure makes the heart work harder than when blood pressure is within a normal range. When blood pressure is high over time, the heart enlarges and weakens. High blood pressure increases the degree of risk a person has for heart attack, stroke, kidney failure, and congestive heart failure. When other risk factors such as obesity, smoking, high cholesterol, or diabetes co-exist, the risk of heart attack or stroke increases several times over.
  • Obesity. Even if a person has no other risk factors, their excess body fat subjects them to a greater risk of developing heart disease and stroke. Being obese is related to coronary heart disease because it has an influence on blood pressure, blood cholesterol and triglyceride levels, and lays a foundation for diabetes to develop.
  • Diabetes Mellitus. Approximately 75% of people with diabetes have some type of heart or blood vessel disease identified as their cause of death. Diabetes is a major risk factor for developing cardiovascular disease. Even when a person’s glucose levels are well controlled they are at risk for heart disease and stroke.
  • Lack of Physical Activity. Physical inactivity is considered one of the lifestyle considerations in assessing risks of coronary heart disease. Unfortunately, many consumers with developmental disabilities, including persons who have limited mobility, tend to lead somewhat sedentary lifestyles. Exercise plays an important role in controlling blood cholesterol, diabetes, and obesity. In some people, exercise is beneficial in lowering blood pressure. Benefits in the prevention of heart and blood vessel disease can be found in regular, moderate-to-vigorous exercise. People who engage in moderate-intensity physical activity on a regular, long-term basis can also accrue preventative benefits.

Risk Factors that cannot be Changed

  • The Aging Process. Although men, women, and children of all ages can develop cardiovascular diseases or conditions, the older a person is, the greater the risk. Approximately 85% of people whose deaths were caused by coronary heart disease were age 65 or older.
  • Heredity, including Racial Considerations. A family history of heart attack, stroke, or other cardiovascular disease is considered a major risk factor for any person. The incidence of high blood pressure in people who are African American increases their risk of developing heart disease.
  • Gender. Men have a greater risk of heart attack than women, and these attacks generally occur earlier in life. Stroke is also more common in men than in women. It should be noted, however, that women actually account for more than half of all deaths due to stroke. Pregnant women have a higher stroke risk, as do women who both smoke and take contraceptives as noted above.
  • History. If a person has already had a heart attack or stroke, he or she is more likely to develop additional problems, including another heart attack or stroke. A consumer’s history of cardiovascular disease and treatment provides critical information for preventing or minimizing the impact of future health problems.

Handy Online Resource
The American Stroke Association has developed the Heart and Stroke Encyclopedia, a seemingly exhaustive reference guide to diseases of the heart and circulatory system. From Aneurysm to Xanthomas, the information is current and presented in interesting and understandable formats. The Encyclopedia is available online for ready access to information and resources on cardiovascular health.

To view The Heart and Stroke Encyclopedia, go to:

http://local.strokeassociation.org/presenter.jhtml?identifier=10000067




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