NEET PG High-Yield: Coronary Heart Disease (CHD)
CHD, often referred to as Ischemic Heart Disease (IHD), is the leading cause of mortality globally and in India. Its epidemiology is centered on a complex interaction of modifiable and non-modifiable risk factors.
Classification of Risk Factors
| Non-Modifiable | Modifiable (Major) |
|---|---|
| Age | Hypertension |
| Gender (Male > Female) | Dyslipidemia (High LDL, Low HDL) |
| Family History/Genetics | Smoking/Tobacco Use |
| Ethnicity | Diabetes Mellitus |
Key Epidemiological Concepts
- The “Interheart” Study: A landmark study identifying 9 modifiable risk factors that account for >90% of the population-attributable risk for a first Myocardial Infarction.
- Metabolic Syndrome: A cluster of conditions (Abdominal obesity, High BP, High Fasting Glucose, High Triglycerides, Low HDL) that significantly elevates CHD risk.
- Primary Prevention: Focused on lifestyle modification (DASH diet, physical activity, smoking cessation) and control of hypertension/diabetes.
High-Yield NEET PG Pearls:
- Framingham Risk Score: The standard tool for calculating the 10-year risk of developing CHD.
- Emerging Risk Factors: Elevated Lipoprotein(a), High-sensitivity C-Reactive Protein (hs-CRP), and Homocysteine levels.
- Smoking: The most significant *preventable* risk factor; cessation reduces risk rapidly.
- Socioeconomic Status: An independent determinant that influences dietary habits and stress levels.