Environmental Genetic & Psychosocial Factors Impacting Cardio Health

Cardiovascular diseases (CVDs) include primarily heart attack and paralysis (stroke). These are the leading causes of death across the world and a major contributor to disability and change in quality of life. Prevalent cases of total CVD nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019 based on Global burden study.

Multiple initiatives have been taken by various organizations to understand modifiable risk factors and addressing the life style related risk factors. Various risk calculators for predicting the occurrence of heart attack and cardiovascular events have been developed based on underlying co-morbid conditions explained in a separate column on this website.

A ) Family History of Coronary Artery Disease (Heart Attack): A family history of premature CVD is useful information that can prompt comprehensive risk assessment in individuals with a family history of premature CVD. Any male relative with age < 55 year and female relative with age < 65 year old with history of coronary artery disease is recommended risk assessment for Coronary Artery Disease.

B) Psychosocial Stress: Studies have reported the Psychosocial stress to be associated with major cardiovascular event increasing the chances anywhere between 20% to 100%. On the other hand, indicators of mental well being and good mental health such as optimism and a strong sense of purpose are associated with lower risk. In SUPRIM (Secondary Prevention in Uppsala Primary Health Care project), patients in the intervention group with well managed stress risk factors had a 41% lower rate of fatal and non-fatal first recurrent Atherosclerotic cardiovascular events and fewer recurrent heart attacks.

C) Ethnicity and Nationality: Based on QRISK 3 study conducted in UK among various ethnicities, it was found that relative risk of CVD among Indians and Bangladeshi are higher. Overall the risk of heart disease is 30% higher for Indians and Bangladeshis based on the results of this study.

D) AIR POLLUTION: Air pollution has been emerging as leading modifiable risk factor for cardiovascular disease. Loss of life-expectancy due to ambient air pollution has been estimated at 2.9 years, accounting for an estimated global excess mortality of 8.8 million per year. Fine particular matters (<2.5 µm; PM2.5 ) are primarily associated with increase in incidence of heart attacks and overall mortality. An average 1.0% increase of all-cause mortality for an increment of 10 μg/m3 in exposure to PM2.5. ASCVD Risk Assessment is strongly encouraged for individuals exposed to high level of pollution for long time.

References:

1. https://academic.oup.com/eurheartj/article/42/34/3227/6358713

2. https://www.thelancet.com/gbd