Van Gool & Bridges
obesity, socio-economic status, Aboriginal background and ethnicity are risk factors for
CHD.
The term ‘risk factor’ was first used in relation to CHD in 1961 in a paper analysing the
Framingham study. WHO (1994) states that these risk factors serve two purposes:
1. to detect individuals and populations with an elevated risk of CHD; and
2. to determine the causes of CHD.
Risk factors refer to the modifiable biological and behavioural characteristics of
individuals and/or populations that have been identified as being linked with increased
rates of CHD (WHO, 1994). Until recently, focus has been upon the biological risk
factors such as cholesterol levels, hypertension and Body Mass Index (BMI). WHO
(1994) found that behavioural and lifestyle risk factors, in particular, dietary habits,
have often been neglected under the heading of risk factors.
Hopkins and Williams (1981) identified 246 potential risk factors attributed to increases
in rates of CHD. Through a review of the literature, this study reduced the number of
risk factors to a workable number. For this exercise a good starting point was Lawrence
et al (ed.) (1996), who performed a similar exercise for cardio-vascular disease (CVD)
in general. Further evidence was sought to focus specifically on CHD and to give an
Australian focus to this project.
Risk Factors Used in this Analysis
WHO (1994) states that the term ‘risk factor’ should be used pragmatically. That is, as
a label for those factors that actually predict the risk of CHD. From the point of view of
prevention, it is important to establish a cause and effect relationship. This is not to say
that a risk factor that is not causally linked does not affect risk of CHD (WHO, 1994).
Rather, one has to use this double-edged sword if one is successfully going to reduce
the number of risk factors to a workable number.
Appendix B supplies evidence on the risk factors of CHD. The risk factors examined in
this paper are:
1. serum LDL cholesterol levels;
2. systolic blood pressure;
3. BMI; and
4. sedentary lifestyle.
5 Chere Project Report Il- November 1999