well-known risk factors for coronary atherosclerosis and heart attacks are: elevated levels of ldl cholesterol (the "bad" cholesterol) in the blood. family history of early coronary heart disease including a heart attack or sudden death before age 55 in the father or other male first-degree relative or before age 65 in the mother or other female first-degree relative. cigarette smoking. diabetes. high blood pressure. low levels of hdl (the "good" cholesterol) in the blood. sedentary lifestyle. less recognized but just as important risk factors for coronary atherosclerosis are: a preponderance of small ldl cholesterol particles in the blood. ldl cholesterol particles come in different sizes. the size of a person's ldl cholesterol particles is predominantly genetically inherited. the smaller ldl cholesterol particles are far more dangerous in causing atherosclerosis than the larger particles. the smaller ldl particles can penetrate the walls of the arteries more easily than the larger ldl particles. a person with an abundance of small ldl cholesterol particles in the blood has a significantly higher risk of heart attack and coronary atherosclerosis than someone with larger ldl cholesterol particles in their blood. abnormally elevated blood levels of lipoprotein a (lp(a)). lp(a) is an ldl cholesterol particle that is linked chemically to a protein called apo(a). the level of lp(a) in the blood is also genetically inherited. men and women with elevated blood levels of lp(a) have significantly higher rates of coronary atherosclerosis and heart attacks. elevated homocysteine levels in the blood. homocysteine is a metabolic by-product of animal protein. tests are now available to measure homocysteine levels in the blood. higher homocysteine levels in the blood are associated with atherosclerosis in coronary arteries and carotid arteries (arteries that supply blood to the brain).
what are the risk factors for coronary atherosclerosis and heart disease?