Estimating the Risk of
Coronary Heart Disease
Laboratory Activity
ESTIMATING RISK OF CORONARY HEART DISEASE – (CHD)
INTRODUCTION
In this activity you will do what doctors do when they see patients for heart problems. One of the
main things they do is take a case history of their patients. A case history is all the information about a
person’s habits, health, and background. This activity will show how certain factors can be used to help
predict if a person will have CORONARY HEART DISEASE.
We have periodically spoken of factors thought to be related to the occurrence of heart disease.
For example, if all other factors are equal, a person with a poor diet with respect to CHD (too much fat,
sugar, etc.), is thought to be more likely to end up with CHD than a person on a good diet (low fat, low sugar,
etc). This does not say that either individual necessarily will or won’t have CHD as we are dealing with
statistical relationships rather than with a simple cause and effect relationship. In general, the higher your
total risk factor, the more likely that you will get CHD. In other words, the relative frequency of CHD will tend
to be higher in a group of people with high risk factors. It is important to learn about the CHD risk factors to
avoid loading the dice in favor of CHD. Avoiding unnecessary risks is an important part of preventative
medicine.
For our study of risk factors, we will use Table 1. This table is modified from one produced by the
Michigan Heart Association. Similar tables of CHD risk factors have been produced by different groups.
Some charts include a few different risk factors such as personal stress, vital lung capacity, and diabetes.
In addition, charts of heart risk factors are not identical in the way they rate the relative importance of each
factor. Some rate nutritional factors highest, others rate smoking or blood pressure highest. All of these
charts are useful however since they tell people whether they should be concerned about the risk of CHD
and they suggest ways for individuals to lower their risk.
In Table 1, nine risk factors are listed. For each risk factor, the degree of risk increases from left to
right. Note that for age 10-20 the risk is 1, but for age 61 and over the risk factor is 8. This means that
people over 60 are considerably more likely to have CHD than those under 20. It does not necessarily mean
the older individuals are eight times as likely to have CHD than the younger group.
Look at the 9 factors in Table 1 that are related to coronary heart disease. Each factor is listed with
numbers corresponding to the risk of having heart disease. For example a person with a poor diet is more
likely to end up with coronary heart disease than a person with a good diet and will have a higher number on
the chart. The higher a person’s total number for all of the risk factors, the higher their chance for heart
disease.
PROCEDURE
1. Copy the data table below on to your own paper.
Rose
Age
Sex
Weight
Blood
Cholesterol
% Calories from
saturated fat
Systolic Blood
Pressure
Tobacco
Smoking
Exercise
Family History
TOTAL SCORE
Tom
Freddie
Maria
Mrs. Jones
TABLE 1
1. Age
10-20
21-30
31-40
41-50
51-60
61 and over
1
2
3
4
6
8
Female 40-50
Female over 50
Male
1
2
3
5
More than 2 kg
below standard
weight
Standard
weight + 2 kg
3-10 kg
overweight
11-30 kg
overweight
31-40 kg
overweight
40 or more kg
overweight
0
1
2
3
4
5
4. Blood
Cholesterol
Level
< 180
181-205
206-230
231-255
256-280
281-300
0
1
2
3
4
5
5. % of total
calories from
saturated fat
< 10
11-20
21-30
31-40
41-50
> 50
0
1
2
3
4
5
6. systolic
blood
pressure
100-120
121-140
141-160
161-180
181-200
> 200
1
2
3
4
6
8
7. Smoking
Non-smoker
Cigar/pipe
< 10 cigarettes
per day
11-20 cigarettes
per day
21-30 cigarettes
per day
> 30 cigarettes
per day
0
1
2
4
6
10
Intense
regular
exercise
Moderate
regular
exercise
Intense
Recreational
exercise only
Moderate
recreational
exercise
Light
recreational
exercise
Complete
lack of
exercise
1
2
3
5
6
8
No known family
history
1 relative had
CHD after age 60
2 relatives had
CHD after age 60
1
2
3
1 relative had
CHD before age
60
2 relatives had
CHD before age
60
3 relatives had
CHD before age
60
2. Sex
3. Weight
8. Exercise
9. Family
History
Female < 40
4
6
7
2. Use the following case histories and the accompanying RISK FACTOR CHART to fill in data table.
CASE #1 – Rose
CASE #2 – Tom
Age: 29
Age: 47
Weight: 1 kg over standard wt
Weight: 9 kg over standard wt
Blood Cholesterol: 200
Blood Cholesterol: 235
% Calories from Saturated Fat: 30%
Calories from Saturated Fat: 44
Blood Pressure: 120/80
Blood Pressure: 160/90
**Smoking: none
**Smoking: 2 packs/day
Exercise: exercises at work and for recreation
Exercise: none
Family History: both parents and grandfather had
Family History: 1 grandfather had early CHD
CHD in their 50’s
CASE #3 – Freddie
CASE #4 – Maria
Age: 52
Age: 29
Weight: 11 kg over standard wt
Weight: 2 kg below standard wt
Blood Cholesterol: 260
Blood Cholesterol: 185
% Calories from Saturated Fat: 44
Calories from Saturated Fat: 24
Blood Pressure: 170/100
Blood Pressure: 80/60
**Smoking: 1 ½ packs/day
**Smoking: 3 packs/day
Exercise: watching football on tv (NONE)
Exercise: occasional walking
Family History: father, brother, grandfather had
Family History: none
CHD in their 60’s
**Assume there are 20 cigarettes per pack
CASE #5 – Mrs. Jones
Age: 40
Weight: 35 kg over standard wt
Blood Cholesterol: 270
% Calories from Saturated Fat: 41
Blood Pressure: 160/100
**Smoking: none
Exercise: none
Exercise: none
Family History: father died of heart attack in his 50's
EVALUATING TOTAL RISK FACTOR: TOTAL SCORE
SCORE
5-11
12-18
19-24
25-31
32-40
41-63
RISK
well below average
below average
average
moderate
high
much too high
Copy the following questions on your own paper and write complete sentence answers.
1. List each of the 5 case studies total score and risk for CHD. Use the TOTAL SCORE chart above.
2. For each individual at high risk, what SPECIFIC ADVICE would you give them to help them decrease their
risk of CHD?
3. If you have a family history of CHD does that mean that you will have CHD? Explain your answer.
4. In this lab there are 9 risk factors. What are the risk factors that you can control and how would you
control each one?
CHD Lab Guidelines & Answer Key
This lab is somewhat self explanatory to administer. I will discuss the introduction with the
class together first. I have a class set of instructions made and then have the students
make their own data table. The students will then fill in the data table using Table 1, and
answer the discussion questions at the end with complete sentences. Depending on your
level of student you may want to add to the discussion questions.
Answer Key
Rose
Tom
Freddie
Maria
Mrs. Jones
Age
2
4
6
2
3
Sex
1
5
5
1
2
Weight
1
2
3
0
5
Blood
Cholesterol
1
3
4
4
4
% Calories from
saturated fat
2
4
4
2
4
Systolic Blood
Pressure
1
3
4
1
3
Tobacco
Smoking
1
10
6
10
0
Exercise
1
8
8
2
8
Family History
7
4
2
1
4
TOTAL SCORE
17
43
42
23
33
DISCUSSION QUESTIONS
1. Tom Young - highest
Maria – lowest
2. Various answers can be given – more exercise, quit smoking, better diet, etc
3. Not necessarily – but does have a higher risk
4. Not necessarily – but chances are good they won’t