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Uncontrollable factors
The Framingham coronary risk score sheet uses both uncontrollable and controllable risk factors. Among uncontrollable risk factors, it takes into account only age and gender, which strongly correlate with heart disease. Men tend to have a greater overall risk of heart attack than women, beginning earlier in life.
However, women’s risk of heart attack rises after menopause and heart disease is the leading killer of American women. Also, many forms of heart disease, such as atherosclerosis, tend to affect older people more often than younger people.
There are other known risk factors for heart disease that are not included on the Framingham score sheet. These include:
- A family history of cardiovascular disease.
- Race. According to the American Heart Association, blacks (both male and female) are more likely to have coronary artery disease (CAD) than whites. Proportionately, CAD claims more black and white lives than Hispanic lives. Black women and Native American women are more likely to have a heart attack than white women.
- Congenital disease heart. These are conditions that are present at birth. Although there is no known cause or preventive measures to protect against congenital heart disease, researchers are pursuing possible genetic causes that may someday lead to better therapies and diagnostic tools.
- Patient history. Patients who have had cerebral vascular disease (e.g., stroke) are at higher risk of developing CAD.
Controllable factors
Similarly, the Framingham coronary risk score sheet uses only a few of the known controllable risk factors to measure risk. These include cholesterol levels, smoking and blood pressure. Other controllable risk factors that are not included on the Framingham coronary risk score sheet include:
- Lack of regular exercise
- Eating a high-fat, high-cholesterol diet
- Obesity (defined as having a body index mass greater than 30)
- Uncontrolled stress or anger
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