scholarly journals Risk Factors of Premature Coronary Artery Disease

2021 ◽  
Vol 25 (1) ◽  
pp. 145-150
Author(s):  
Mujaddid Mudassir ◽  
Javed Iqbal ◽  
Muhammad Shafique Arshad ◽  
Ali Raza ◽  
Qudsia Anjum Qureshi
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Dietary Habits ◽  
Sedentary Lifestyle ◽  
Age Group ◽  
Younger Age ◽  
Premature Cad ◽  
Stress Score ◽  
Artery Disease

Introduction: Coronary artery disease (CAD) is one of the commonest and leading causes of death throughout the world. It is becoming common in the younger age group as well. This study was carried out to analyze the risk factors present in young patients who presented with acute Myocardial Infarction (M.I). Materials and Methods: In this descriptive cross-sectional study, we included 120 patients of age 20-35 years of age who presented with the first episode of acute M.I. Study was conducted at Pakistan Institute Of Medical Sciences, Islamabad, department of cardiology for all patients with first MI from 1st February 2016 to 31st January 2018. Twelve risk factors were studied including Gender, Hypertension, Diabetes mellitus, dyslipidemia, sedentary lifestyle, family history of premature CAD, obesity, smoking, dietary habits, profession, socioeconomic stress, drug addictions. The frequency of risk factors was calculated. Results: Results showed that some of the risk factors were present in higher proportion e.g. smoking, sedentary lifestyle, poor dietary habits, and stressful socioeconomic conditions. Most of the patients in the younger age group were drivers. The results of our study showed that male patients were higher(93.3%) in proportion to female patients (6.7%). 33% of patients were drivers, 13% plumbers, 13% shopkeepers, 10% businessmen, 8% laborers, 5% policemen, 5% students, 5% bank officers, 3% engineers, 2% teachers, 1% doctors. 68.3% of patients were smokers. 58.3% of patients were having high-stress scores. 23.3% of patients were having moderate stress score.18.3% were having a low-stress score. 56% of patients were having dyslipidemia.48% of patients were obese. Family history was present in 26.7% of patients. Conclusion: For patients presenting with premature CAD, Some of the modifiable risk factors include hypertension, sedentary lifestyle, fatty dietary habits, obesity, smoking, diabetes, dyslipidemia. The profession also affects the development of IHD as is evident from our study. So primary preventive strategies need to be implied to prevent the development of IHD, especially in individuals who are at risk.

P4455The controversial role of genetics behind premature CAD: a plausible excuse for the young?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Sousa ◽  
M Mendonca ◽  
A Pereira ◽  
F Mendonca ◽  
M Neto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Score ◽  
Genetic Risk ◽  
Genetic Risk Score ◽  
Young Patients ◽  
Premature Cad ◽  
Artery Disease ◽  
Group B

Abstract Introduction The complex interaction between genes and environmental factors contribute to individual-level risk of coronary artery disease (CAD), often resulting in premature CAD. The role for genetic risk scores in premature CAD is still controversial. Objective To evaluate the importance of conventional risk factors and of a genetic risk score in younger and older patients with coronary artery disease Methods From a group of 1619 pts with angiographic documented CAD from the GENEMACOR study, we selected 1276 pts admitted for ACS and analysed them in 2 groups (group A: ≤50 years, n=491 pts, 87.2% male, mean age 44±4.9 and group B: >50 years, n=785 pts, 75.2% male, mean age 57±4.2). Univariate analysis was used to characterize the traits of each group and we used ROC curves and respective AUCs to evaluate the power of genetics in the prediction of CAD, through a Genetic Risk Score (GRS). Results 99.3% of the young patients had at least one modifiable risk factor, 18.4% had 2 modifiable risk factors and 75.2% had 3 or more modifiable risk factors. The pattern of risk factors contributing to CAD were different among groups: family history (A: 27.5%, B: 21.4%, p=0.015) and smoking habits (A: 64.8%, B: 42.9%, p<0.001) were more frequent among patients under 50, and traditional age-linked factors like hypertension (A: 58%, B: 75.7%, p<0.001), diabetes (A: 21.6%, B: 38.6%, p<0.001) were more common in the older group. Acute ST-elevation myocardial infarction was more frequent among the young (A: 55.4%, B: 47.4%, p=0.006), as non-ST clinical presentation was higher among elder patients. Regarding angiographic presentation, single vessel CAD was higher in group A (A: 50.3%, B: 40.9%, p<0.001), while multivessel diasease was higher in group B (A: 33.3%, B: 53.9%, p<0.001). At a mean follow-up of 5 years, older patients had a worst prognosis, registering a higher rate of cardiovascular death (A: 4.1%, B: 8.6%, p=0.002) and higher MACE (A: 26.8%, B: 31%, p=0.128),. Adding the genetic risk score (GRS), we achieved only a slight improvement in the AUC for predicting CAD (0.796->0.805, p=0.0178 and 0.748->0.761, p=0.0007 in patients under and over 50, respectively). Conclusion Coronary artery disease is not all the same, as premature CAD shares a unique and specific pattern of risk factors, clinical presentation, angiographic severity and prognosis. Genetics should not be used as an excuse to justify premature CAD, as there is frequently more than one potentially reversible risk factor present even in young patients and the additive predictive value of GRS is modest.

scholarly journals Top Three Risk Factors of Coronary Artery Disease in Chittagong, Bangladesh

2017 ◽  
Vol 16 (1) ◽  
pp. 26-28
Author(s):  
Abu Tarek Iqbal ◽  
M Jalal Uddin ◽  
Shaikh Md Hasan Mamun ◽  
Rajat Sankar Roy Biswas
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Age Group ◽  
Primordial Prevention ◽  
Male Preponderance ◽  
The Subject ◽  
Artery Disease ◽  
Type 2 Diabetic

Background: Many studies were conducted on the subject in home and abroad but there is none in Chittagong, Bangladesh. To know about top three risk factors for coronary artery disease we conducted the study.Methods: It was a retrospective study. Records of a private cardiac center from July 2013 to June 2014 was collected. Only coronary stenosed cases (As per angiogram) was studied. Age, sex, BMI, diabetes mellitus, hypertension, smoking and other risk factors were considered. Collected data was managed manually. Finally discussion was made and conclusion was done.Results: Majority cases 58(76%) were of 40-60 years age group. Male preponderance was there 64(83%). BMI of 45(60%) cases was normal (<25). Family history was positive among 11(14%) cases. Dyslipidemia was found in 08(10%) cases, 56(73%) cases were hypertensive, 43(56%) cases were type-2 diabetic and 35(45%) were smoker.Conclusion: Hypertension, Diabetes and Smoking are top 03 risk factors for coronary artery disease. All are modifiable. So, primordial prevention should be taken to reduce prevalence of coronary artery disease.Chatt Maa Shi Hosp Med Coll J; Vol.16 (1); Jan 2017; Page 26-28

scholarly journals Coronary plaque tissue characterization in patients with premature coronary artery disease

2020 ◽  
Vol 36 (6) ◽  
pp. 1003-1011
Author(s):  
Jianchang Xie ◽  
Jie Qi ◽  
Hengyi Mao ◽  
Ningfu Wang ◽  
Xianhua Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Plaque ◽  
Plaque Burden ◽  
Premature Coronary Artery Disease ◽  
Coronary Risk Factors ◽  
Matching Procedure ◽  
Premature Cad ◽  
Artery Disease

Abstract Premature coronary artery disease (CAD) studies rarely involve coronary plaque characterization. We characterize coronary plaque tissue by radiofrequency intravascular ultrasound (IVUS) in patients with premature CAD. From July 2015 to December 2017, 220 patients from the Department of Cardiology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine with first occurrence of angina or myocardial infarction within 3 months were enrolled. Patients with premature CAD (n = 47, males aged < 55 years, and females aged < 65 years) or later CAD (n = 155) were retrospectively compared for cardiovascular risk factors, laboratory examination findings, coronary angiography data, gray-scale IVUS, and iMap-IVUS. The mean age was 53.53 ± 7.24 vs. 70.48 ± 8.74 years (p < 0.001). The groups were similar for traditional coronary risk factors except homocysteine (18.60 ± 5.15 vs. 17.08 ± 4.27 µmol/L, p = 0.043). After matching for baseline characteristics, LDL cholesterol (LDL-C) was higher for premature CAD than later CAD (2.50 ± 0.96 vs. 2.17 ± 0.80 mmol/L, p = 0.019). Before the matching procedure, the premature CAD group had shorter target lesion length [18.50 (12.60–32.00) vs. 27.90 (18.70–37.40) mm, p = 0.002], less plaque volume [175.59 (96.60–240.50) vs. 214.73 (139.74–330.00) mm3, p = 0.013] than the later CAD group. After the matching procedure, the premature CAD group appeared to be less plaque burden (72.69 ± 9.99 vs. 74.85 ± 9.80%, p = 0.005), and positive remodeling (1.03 ± 0.12 vs. 0.94 ± 0.18, p = 0.034), and lower high risk feature incidence (p = 0.006) than the later CAD group. At the plaque’s minimum lumen, premature CAD had more fibrotic (p < 0.001), less necrotic (p = 0.001) and less calcified areas (p = 0.012). Coronary plaque tissue was more fibrotic with less necrotic and calcified components in premature than in later CAD, and the range and degree of atherosclerosis were significantly lower.

scholarly journals Risk Factor Burden and Long‐Term Prognosis of Patients With Premature Coronary Artery Disease

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Michel Zeitouni ◽  
Robert M. Clare ◽  
Karen Chiswell ◽  
Jawan Abdulrahim ◽  
Nishant Shah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Premature Cad ◽  
Artery Disease ◽  
Long Term Prognosis

Background Coronary artery disease (CAD) is increasing among young adults. We aimed to describe the cardiovascular risk factors and long‐term prognosis of premature CAD. Methods and Results Using the Duke Databank for Cardiovascular Disease, we evaluated 3655 patients admitted between 1995 and 2013 with a first diagnosis of obstructive CAD before the age of 50 years. Major adverse cardiovascular events (MACEs), defined as the composite of death, myocardial infarction, stroke, or revascularization, were ascertained for up to 10 years. Cox proportional hazard regression models were used to assess associations with the rate of first recurrent event, and negative binomial log‐linear regression was used for rate of multiple event recurrences. Past or current smoking was the most frequent cardiovascular factor (60.8%), followed by hypertension (52.8%) and family history of CAD (39.8%). Within a 10‐year follow‐up, 52.9% of patients had at least 1 MACE, 18.6% had at least 2 recurrent MACEs, and 7.9% had at least 3 recurrent MACEs, with death occurring in 20.9% of patients. Across follow‐up, 31.7% to 37.2% of patients continued smoking, 81.7% to 89.3% had low‐density lipoprotein cholesterol levels beyond the goal of 70 mg/dL, and 16% had new‐onset diabetes mellitus. Female sex, diabetes mellitus, chronic kidney disease, multivessel disease, and chronic inflammatory disease were factors associated with recurrent MACEs. Conclusions Premature CAD is an aggressive disease with frequent ischemic recurrences and premature death. Individuals with premature CAD have a high proportion of modifiable cardiovascular risk factors, but failure to control them is frequently observed.

scholarly journals Fibrinogen and a Triad of Thrombosis, Inflammation, and the Renin-Angiotensin System in Premature Coronary Artery Disease in Women: A New Insight into Sex-Related Differences in the Pathogenesis of the Disease

Biomolecules ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1036
Author(s):  
Karolina E. Kryczka ◽  
Mariusz Kruk ◽  
Marcin Demkow ◽  
Barbara Lubiszewska
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Young Women ◽  
Plaque Formation ◽  
Tissue Type ◽  
Premature Coronary Artery Disease ◽  
Renin Angiotensin ◽  
Premature Cad ◽  
Artery Disease

Coronary artery disease (CAD) is the leading cause of morbidity and mortality in women worldwide. Its social impact in the case of premature CAD is particularly devastating. Many differences in the presentation of the disease in women as compared to men, including atypical symptoms, microvascular involvement, and differences in pathology of plaque formation or progression, make CAD diagnosis in women a challenge. The contribution of different risk factors, such as smoking, diabetes, hyperlipidemia, or obesity, may vary between women and men. Certain pathological pathways may have different sex-related magnitudes on CAD formation and progression. In spite of the already known differences, we lack sufficiently powered studies, both clinical and experimental, that assess the multipathogenic differences in CAD formation and progression related to sex in different age periods. A growing quantity of data that are presented in this article suggest that thrombosis with fibrinogen is of more concern in the case of premature CAD in women than are other coagulation factors, such as factors VII and VIII, tissue-type plasminogen activator, and plasminogen inhibitor-1. The rise in fibrinogen levels in inflammation is mainly affected by interleukin-6 (IL-6). The renin–angiotensin (RA) system affects the inflammatory process by increasing the IL-6 level. Unlike in men, in young women, the hypertensive arm of the RA system is naturally downregulated by estrogens. At the same time, estrogens promote the fibrinolytic path of the RA system. In young women, the promoted fibrinolytic process upregulates IL-6 release from leukocytes via fibrin degradation products. Moreover, fibrinogen, whose higher levels are observed in women, increases IL-6 synthesis and exacerbates inflammation, contributing to CAD. Therefore, the synergistic interplay between thrombosis, inflammation, and the RA system appears to have a more significant influence on the underlying CAD atherosclerotic plaque formation in young women than in men. This issue is further discussed in this review. Fibrinogen is the biomolecule that is central to these three pathways. In this review, fibrinogen is shown as the biomolecule that possesses a different impact on CAD formation, progression, and destabilization in women to that observed in men, being more pathogenic in women at the early stages of the disease than in men. Fibrinogen is a three-chain glycoprotein involved in thrombosis. Although the role of thrombosis is of great magnitude in acute coronary events, fibrinogen also induces atherosclerosis formation by accumulating in the arterial wall and enabling low-density lipoprotein cholesterol aggregation. Its level rises during inflammation and is associated with most cardiovascular risk factors, particularly smoking and diabetes. It was noted that fibrinogen levels were higher in women than in men as well as in the case of premature CAD in women. The causes of this phenomenon are not well understood. The higher fibrinogen levels were found to be associated with a greater extent of coronary atherosclerosis in women with CAD but not in men. Moreover, the lysability of a fibrin clot, which is dependent on fibrinogen properties, was reduced in women with subclinical CAD compared to men at the same stage of the disease, as well as in comparison to women without coronary artery atherosclerosis. These findings suggest that the magnitude of the pathological pathways contributing to premature CAD differs in women and men, and they are discussed in this review. While many gaps in both experimental and clinical studies on sex-related differences in premature CAD exist, further studies on pathological pathways are needed.

scholarly journals Genetic Markers for Coronary Artery Disease

Medicina ◽  
2018 ◽  
Vol 54 (3) ◽  
pp. 36 ◽  
Author(s):  
Nevena Veljkovic ◽  
Bozidarka Zaric ◽  
Ilona Djuric ◽  
Milan Obradovic ◽  
Emina Sudar-Milovanovic ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Genetic Markers ◽  
Dietary Habits ◽  
Sedentary Lifestyle ◽  
Developed Countries ◽  
Behavioral Risk ◽  
Causes Of Mortality ◽  
Artery Disease ◽  
English Articles

Coronary artery disease (CAD) and myocardial infarction (MI) are recognized as leading causes of mortality in developed countries. Although typically associated with behavioral risk factors, such as smoking, sedentary lifestyle, and poor dietary habits, such vascular phenotypes have also long been recognized as being related to genetic background. We review the currently available data concerning genetic markers for CAD in English and non-English articles with English abstracts published between 2003 and 2018. As genetic testing is increasingly available, it may be possible to identify adequate genetic markers representing the risk profile and to use them in a clinical setting.

scholarly journals Prevalence of diabetic dyslipidaemia in younger age group

2017 ◽  
Vol 16 (4) ◽  
pp. 557-563 ◽  
Author(s):  
Susmita Sarkar ◽  
Indranil Dawn
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cerebrovascular Accident ◽  
Age Group ◽  
Diabetic Dyslipidemia ◽  
Adult Age ◽  
Younger Age ◽  
Artery Disease ◽  
Type 2 Diabetic

Background: The commonest cause of mortality & morbidity in Type 2 diabetes is cerebrovascular accident & coronary artery disease. The study shows that only good blood glucose control, along with BP control in Type 2 diabetic patients cannot reduce mortality & morbidity due to cerebrovascular accident & coronary artery disease; but dyslipidaemia & life style modification is the cornerstone to reduce mortality & morbidity for those events. Dyslipidaemia in diabetes mellitus is a common accompaniment. Prevalence of lipid profile abnormality may not uncommon in young Type 2 diabetics which is common in elderly Type 2 diabetic patients.Aims: The aim of the study is to look after the prevalence of dyslipidaemia in younger age group & to compare it with elderly age group with the same anthropometric parameters.Methodolgy: A prospective cohort study was undertaken to find out the prevalence of diabetic dyslipidemia in younger and adult age group among patients attending Medical OPD & Diabetic clinic in M.G.M. Medical college &L.S.K. Hospital, Kishanganj, Bihar& to compare it between young and adult age group.Results: In the present study majority of patients of older age group have high LDL and low HDL in comparison to younger age group. Increased triglyceride level is not significantly high.Conclusion: Aggressive therapy of diabetic dyslipidemia will probably reduce the risk of CHD in patients with diabetes. Primary therapy should be directed first at lowering LDL levels & improving HDL levels.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.557-563

scholarly journals Risk factors for coronary artery disease among judicial officers.

2020 ◽  
Vol 27 (12) ◽  
pp. 2591-2595
Author(s):  
Naeem Hameed ◽  
Shahid Abbas ◽  
Faisal Ali ◽  
Muhammad Akram ◽  
Shahid Iqbal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Sedentary Lifestyle ◽  
Disease Risk ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Artery Disease ◽  
Significant Disease ◽  
Conventional Risk Factors

Objectives: Objective of this study was to find out the prevalence of risk factors for coronary artery disease in very important group of population who are expected to have sedentary lifestyle. Study Design: Cross-Sectional study. Setting: Faisalabad Institute of Cardiology, Faisalabad. Period: January 2015 to June 2017. Material & Methods: Officers from age of 25 years to 60 years and of either sex were enrolled in study. FLP, FBS, BP, weight and height were measured at FIC. Frequency of coronary artery disease risk factors including Diabetes, HTN, smoking, dyslipidemia, physical activity and obesity was noted considering diagnostic criteria. Results: Mean age was 40.86 ± 7.49, 84.4% (n=76) were male, 15.6% (n=14) were females, 11.1% (n=10) were diabetic, 88.9% (n=80) were non-diabetic, 4 were known case of ischemic heart disease with one having CABG. Smoking was present in 27.8%(n=25). Hypertension was found in 22.2%(n=20). LDL cholesterol was raised in 24.4%(n=22) officers. 46.7%(n=42) were having high BMI i.e.>25.  A high proportion was found to have sedentary lifestyle with 72.2%(n=65) being physically less active. Conclusion: Major conventional Risk factors for coronary artery disease are prevalent in young healthy judicial officers who were not patient of any significant disease.

scholarly journals Risk Factor Patterns for Premature Versus Late-Onset Coronary Artery Disease in Iran: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 13 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Negar Morovatdar ◽  
Yones Bondarsahebi ◽  
Nastaran Khorrampazhouh ◽  
Seyyed A. Hozhabrossadati ◽  
Konstantinos Tsarouhas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Odds Ratio ◽  
Late Onset ◽  
Meta Analysis ◽  
Scientific Information ◽  
Premature Cad ◽  
Artery Disease

Background: There are few data regarding the risk factors of premature vs late-onset Coronary Artery Disease (CAD). This study systematically reviews these risk factors in Iranian people. Methods: Medline, Web of Science, Embase and SID (Scientific Information Database; www.sid.ir) databases were searched for studies comparing CAD risk factors in young and older patients in Iran. Data extracted and pooled odds ratio (OR) with 95% Confidence Interval (CI) for each risk factor were calculated. Publication bias was evaluated by Egger’s test. Results: Seven studies (9080 participants) were included in the meta-analysis; analysis was carried out independently for each risk factor. Smoking (Odds Ratio (OR): 2.57, 95% CI: 1.96-3.37; p=<0.001), family history of CAD (OR: 2.45: 95% CI, 1.44-4.15, p<0.001), opium abuse (OR: 2.44: 95% CI, 1.22-4.88; p=0.001) and hyperlipidaemia (OR: 1.4: 95% CI, 1.13-1.73; p=0.001) were more common in premature CAD compared with older CAD patients. In contrast, diabetes mellitus (OR: 0.54: 95% CI, 0.39-0.73; p=0.0001) and hypertension (OR: 0.36, 95% CI: 0.21-0.59; p<0.001) were less prevalent. Conclusion: Risk factors were significantly different between premature and late-onset CAD. Policies regarding smoking and opium cessation and controlling hyperlipidaemia may be useful for the prevention of premature CAD in Iran.

Risk Factors for Coronary Artery Disease in Patients Undergoing Coronary Angiogram at a Tertiary Level Hospital in Nepal

2022 ◽  
Vol 6 (1) ◽  
Author(s):  
Jeetendra Mishra ◽  
Achutanand Lal Karn ◽  
Alok Kumar Singh ◽  
Asraf Hussain ◽  
Ramji Ram ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Coronary Artery Disease ◽  
Risk Factor ◽  
Coronary Artery ◽  
Family History ◽  
Coronary Arteries ◽  
History Of ◽  
Premature Cad ◽  
Artery Disease

Background: Ischemic heart disease is the leading cause of CVD health loss globally, as well as in each world region, followed by stroke.  In Nepal, CVD was found to be the second most common non-communicable disease among indoor patients of the non-specialist hospital. Age, gender, smoking, obesity, dyslipidemia, physical inactivity, hypertension, and diabetes mellitus (DM) are established risk factors for CVD.  In Nepal, hypertension is found to be the most prevalent risk factor for CVD. Aims and Objectives: This study aimed to assess risk factors for coronary artery disease in patients undergoing coronary angiograms in Nepal. This study also investigated the socio-demographic characteristics of the participants and the nature of the involvement of coronary arteries. Materials and Methods: We examined in this cross-sectional study a total of 74 patients who underwent coronary angiography (CAG) at National Medical College between May 2020 and June 2021. Patients were grouped according to the number of major epicardial coronary arteries involved in SVD, DVD, and TVD. Patients were checked for risk factors like smoking, diabetes mellitus, hypertension, dyslipidemia, family history of coronary artery disease, and obesity. Microsoft Office Excel and SPSS version 21.0 were used for data analysis. The study was approved by the ethical committee. Results: Among 74 participants 53 were male. The mean age was 59.65±10.74 years. Premature coronary artery disease was present in six patients. SVD was the commonest CAD type. Hypertension was the commonest risk factor followed by Diabetes mellitus. Hypertension, Diabetes mellitus, Family history of premature CAD, and obesity were found to be statistically significant. Keywords: CAD, Risk factors for CAD, Premature CAD, Hypertension, Diabetes, obesity, family history of CAD, dyslipidemia, Smoking, SVD, DVD, TVD, Nepal

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