Your patients are likely to know some of the more common risk factors for cardiovascular disease, such as smoking, red meat consumption, and a family history of the condition. However, there are several lesser known risk factors they may not be aware of.

According to the World Health Organization, cardiovascular diseases are the number one cause of death around the globe, with low and middle-income countries and populations comprising three quarters of deaths.¹ Without proper education on risks and prevention, patients may remain at an advanced risk. What are some cardiovascular disease risk factors your patients may not know about?

  1. Refined Grains

A February 2021 study in The BMJ examined the possible association between intake of cereal grains and cardiovascular disease and mortality.² The researchers found that while whole grains and white rice consumption did not play a major role in cardiovascular risk, intake of refined grains was associated with an increased risk in cardiovascular disease and mortality, as well as poor overall cardiovascular health. The investigators concluded that health care professionals should encourage patients to eat cereal grains with a smaller amount of refined wheat products and more whole grains.


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  1. Menopause

Could the age at which women reach menopause play a role in their risk of developing cardiovascular disease? Another study in The BMJ, this one from October 2020, reviewed potential correlations between women’s reproductive health and the risk of developing cardiovascular disease later in life.³ The researchers found that early menopause, both natural and unnatural, often correlated with a higher risk for cardiovascular diseases like ischemic heart disease and composite cardiovascular disease. Physicians may find it beneficial to discuss the link between reproductive health and cardiovascular disease to their female patients who may be at risk.

  1. Thrombosis

While patients may know that smoking puts them at risk for cardiovascular disease, they may not know the many specific ways it can do so. For instance, smoking increases a patient’s risk for thrombosis, a coagulation of blood in the circulatory system that becomes a blood clot.⁴ Patients should know that if they are at risk for or have already developed thrombosis, they are also at a heightened risk for cardiovascular disease.

  1. Childhood Cancer History

Patients with a family history of cardiovascular disease should be aware that they are at risk, but certain patients have an even higher risk depending on their personal medical history. A 2020 study in Cancer Epidemiology, Biomarkers & Prevention looked at cardiovascular outcomes in childhood cancer survivors with a family history of cardiovascular disease and found that family history elevates risk for cardiovascular disease and heart failure.⁵ This can be particularly worrisome, as the researchers note that these patients are already at an advanced risk for cancer therapy-related cardiovascular disease before accounting for family history.

  1. Arthritis and Gout

Rheumatoid arthritis and gout develop in a patient’s body differently, but the way each condition causes inflammation can have a substantial effect on cardiovascular health. A 2020 study published in The Lancet Oncology examined the cardiovascular risks of both rheumatoid arthritis and gout, and concluded that cardiovascular disease risk management is essential in each condition.⁶ Not only do the diseases’ inflammatory natures put patients at risk, but many non-steroidal anti-inflammatory drugs used to treat them can increase risk as well.

References

1. Cardiovascular diseases (CVDs). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Updated June 11, 2021. Accessed August 31, 2021.

2. Swaminathan S, Dehghan M, Raj JM, et al. Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study. BMJ. 2021;372:m4948. Published online 2021 Feb 3. doi:10.1136/bmj.m4948

3. Okoth K, Chandan JS, Marshall T, et al. Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review [published correction appears in BMJ. 2020 Oct 14;371:m3963]. BMJ. 2020;371:m3502. Published 2020 Oct 7. doi:10.1136/bmj.m3502

4. Bays HE, Taub PR, Epstein E, et al. Ten things to know about ten cardiovascular disease risk factors. Am J Prev Cardiol. 2021;5:100149. Published 2021 Jan 23. doi:10.1016/j.ajpc.2021.100149

5. Goldberg JF, Ness KK, Chi X, et al. Cardiovascular family history increases risk for late-onset adverse cardiovascular outcomes in childhood cancer survivors: a St. Jude lifetime cohort report. Cancer Epidemiol Biomarkers Prev. 2021;30(1):123-132. doi:10.1158/1055-9965.EPI-20-0809

6. Hansildaar R, Vedder D, Baniaamam M, Tausche AK, Gerritsen M, Nurmohamed MT. Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout. Lancet Rheumatol. 2021;3(1):e58-e70. doi:10.1016/S2665-9913(20)30221-6

This article originally appeared on The Cardiology Advisor