Risk Factors in the Initial Presentation of Specific Cardiovascular Disease Syndromes

Abdominal Aortic Aneurysm, Acute Myocardial Infarction, Cardiac Arrest, Cardiovascular Diseases, Cerebrovascular Accident, Chronic Stable Angina, Heart Diseases, Heart Failure, Ischemic Stroke, Peripheral Arterial Disease, Subarachnoid Hemorrhage, Sudden Coronary Death, Sudden Death, Transient Ischemic Attack, Unstable Angina, Ventricular Arrhythmia

Heart diseases, Cardiovascular diseases, Coronary heart disease not otherwise specified, Cerebrovascular disorders, Brain diseases, Central nervous system diseases, Nervous system diseases, Atherosclerosis, Arteriosclerosis, Pathologic processes, Acute myocardial infarction, Myocardial infarction, Myocardial ischemia, Infarction, Necrosis, Unstable angina, Chronic stable angina, Stable angina, Angina pectoris, Chest pain, Pain, Signs and symptoms, Ischemia, Ischemic stroke, Hemorrhagic stroke, Stroke, Subarachnoid hemorrhage, Transient ischemic attack, Abdominal aortic aneurysm, Aneurysm, Aortic aneurysm, Aortic aneurysm, abdominal, Aortic diseases, Peripheral arterial diseases, Peripheral vascular diseases, Vascular diseases, Peripheral occlusive diseases, Sudden coronary death, Ventricular arrhythmia, Sudden cardiac death, Cardiac arrest, Heart failure

Cardiovascular disease (CVD) is an important public health problem that affects millions of people worldwide. Associations between risk factors, such as smoking, dyslipidaemia or hypertension, and prevalent CVD are well documented. However, few studies have investigated associations with onset of disease. The initial manifestation of CVD, for example an episode of unstable angina, is important because it influences the prognosis, the quality of life and the management of disease. Furthermore, the extent to which social deprivation, alcohol consumption or atrial fibrillation affects presentation of CVD is poorly understood and deserves further consideration. Most previous studies have considered CVD as a single entity. However, differences in aetiology between coronary phenotypes suggest that risk factors may not be shared across specific coronary phenotypes and their relative importance is likely to differ for each phenotype. Gaining knowledge of these differences could provide insights into the pathophysiology of specific forms of CVD and could eventually lead to modification of recommendations for patient management and disease prevention. We propose to use the linkage of the national registry of coronary events to general practice records in the Clinical Practice Research Database (CPRD), to investigate whether demographic, behavioral, and clinico-metabolic risk factors differentially influence the onset of specific types of CVD.

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