Nama NIM Subject

: Harry Sudarma : 07120080060 : Clinical Exposure Risk Factors

Hypertension (High Blood Pressure) a. Non-Modifiable Risk Factor 1. Age In general, people older than 35 year old is at higher risk. The risk of high blood pressure increases as you age. Through early middle age, high blood pressure is more common in men. Women are more likely to develop high blood pressure after menopause. (Men > 45 year old, Women > 55 year old) 2. Race High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart attack, also are more common in blacks. 3. Family History High blood pressure tends to run in families. 4. Gender Men are generally at greater risk for hypertension than premenopausal women. After menopause, though, a woman's risk increases and is slightly greater than that of a man of the same age.

b. Modifiable Risk Factor 1. Obese The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls. 2. OSA Obstructive sleep apnea, a disorder in which breathing halts briefly but repeatedly during sleep, is present in many patients with hypertension. The relationship between sleep apnea and hypertension has been thought to be largely due to obesity, but studies are finding a higher rate of hypertension in people with sleep apnea regardless of their weight. 3. Smoking Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke can also increase your blood pressure 4. Alcohol Consumption Over time, heavy drinking can damage the heart. Having more than two or three drinks in a sitting can also temporarily raise blood pressure, as it may cause body to release hormones that increase blood flow and heart rate. 5. Diet Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.

 Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood. Too little vitamin D in your diet. It's uncertain if having too little vitamin D in your diet can lead to high blood pressure. Vitamin D may affect an enzyme produced by your kidneys that affects your blood pressure. 6. Stress Being in a stressful situation can temporarily increase your blood pressure, but science has not proven that stress causes high blood pressure. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life, health behaviors and socioeconomic status. How you deal with stress may affect other, established risk factors for high blood pressure or heart disease. For example, people under stress may overeat or eat a less healthy diet, put off physical activity, drink, smoke or misuse drugs 7. Lack of Physical Activity Physical activity is good for your heart and circulatory system. An inactive lifestyle increases the chance of high blood pressure, heart disease, blood vessel disease and stroke. Inactivity also makes it easier to become overweight or obese. Give yourself the gift of improved health and lower blood pressure with regular, moderate-tovigorous physical activity

Cardiovascular risk factors a. Modifiable risk factors 1. Hypertension It is the single biggest risk factor for stroke. It also plays a significant role in heart attacks. It can be prevented and successfully treated but only if you have it diagnosed and stick to your recommended management plan. 2. Abnormal blood lipid levels That is high total cholesterol, high levels of triglycerides, high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL) cholesterol all increase the risk of heart disease and stroke. Changing to a healthy diet, exercise and medication can modify your blood lipid profile. 3. Tobacco use Whether it is smoking or chewing tobacco, increases risks of cardiovascular disease. The risk is especially high if you started smoking when young, smoke heavily or are a woman. Passive smoking is also a risk factor for cardiovascular disease. Stopping tobacco use can reduce your risk of cardiovascular disease significantly, no matter how long you have smoked. 4. Physical inactivity Physical inactivity increases the risk of heart disease and stroke by 50%. Obesity is a major risk for cardiovascular disease and predisposes you to diabetes. Diabetes is a risk factor for cardiovascular disease. 5. Type 2 diabetes It is a major risk factor for coronary heart disease and stroke. Having diabetes makes you twice as likely as someone who does not to develop cardiovascular disease. If you do not control diabetes then you are more likely to develop cardiovascular disease at an earlier age than other

people and it will be more devastating. If you are a pre-menopausal woman, your diabetes cancels out the protective effect of estrogen and your risk of heart disease rises significantly. 6. A diet high in saturated fat increases the risk of heart disease and stroke. It is estimated to cause about 31% of coronary heart disease and 11% of stroke worldwide. 7. Alcohol consumption 8. Certain medicines may increase the risk of heart disease such as the contraceptive pill and hormone replacement therapy (HRT). b. Non-modifiable risk factors 1. Simply getting old is a risk factor for cardiovascular disease; risk of stroke doubles every decade after age 55. 2. Familys history of cardiovascular disease indicates your risk. If a firstdegree blood relative has had coronary heart disease or stroke before the age of 55 years (for a male relative) or 65 years (for a female relative) your risk increases. 3. Gender is significant: as a man you are at greater risk of heart disease than a pre-menopausal woman. But once past the menopause, a womans risk is similar to a mans. 4. Ethnic origin plays a role. People with African or Asian ancestry are at higher risks of developing cardiovascular disease than other racial groups.

Coronary Artery Disease Modifiable CAD Risk Factors Cigarette smoking Obesity 90 mmHg) Physical inactivity Kidney disease Diabetes mellitus Alcohol consumption Stress Kidney disease Elevated LDL Reduced HDL Non-modifiable CAD Risk Factors Males > 45 years Females > 55 years Males disease Hypertension (blood pressure >= 140 / Family history of coronary artery

COPD a. Modifiable-risk factors : 1. Exposure to tobacco smoke. The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and people exposed to large amounts of secondhand smoke also are at risk. Chronic inhalation of marijuana smoke also can be injurious. 2. Occupational exposure to dusts and chemicals. Long-term exposure to chemical fumes, vapors and dusts can irritate and inflame your lungs.

b. Non-modifiable Risk factor 1. Age COPD develops slowly over years, so most people are at least 40 years old when symptoms begin. 2. Genetics. A rare genetic disorder known as alpha-1-antitrypsin deficiency is the source of a few cases of COPD. Researchers suspect that other genetic factors may also make certain smokers more susceptible to the disease.