Coronary artery disease is more common in which of the following?

IGNOU Post B. SC. Nursing entrance -2021

Medical & Surgical Nursing

Hard

Appeared in: IGNOU Post B. SC. Nursing entrance -2021

Explanation

The risk for Coronary Artery Disease (CAD) is cumulative; the presence of multiple risk factors significantly increases the likelihood of developing the disease.
This option combines five major risk factors: hypertension (high blood pressure), smoking, diabetes mellitus, obesity, and male gender.
Hypertension directly damages arterial walls, promoting atherosclerosis.
Diabetes is considered a CAD risk equivalent, as high blood sugar accelerates vascular damage.
Male gender is a non-modifiable risk factor, with men having a higher incidence of CAD than pre-menopausal women.

Option A: This option is incorrect primarily because it lists hypotension (low blood pressure), which is not a risk factor for CAD. Additionally, pre-menopausal women generally have a lower risk than men.
Option B: This option is incorrect because it includes hypotension. While the other factors (smoker, diabetic, obese men) are high-risk, hypertension, not hypotension, is the correct blood pressure-related risk factor.
Option D: This option presents a lower overall risk compared to the correct answer. While hypertension, smoking, and obesity are risk factors, being non-diabetic and female (pre-menopause) confers a lower risk than being diabetic and male.

Clinical Relevance

Nursing practice connection: Knowing Risk factors for Coronary Artery Disease (CAD) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a crucial role in assessing a patient's cardiovascular risk by identifying these factors during health screenings and history taking.
Patient education is a key nursing intervention. Nurses must teach patients about lifestyle modifications such as smoking cessation, dietary changes, regular exercise, and adherence to medications for hypertension and diabetes to reduce their CAD risk.
What if? - If the woman in option D was post-menopausal and had a family history of premature CAD, her risk would increase significantly, making her a high-risk individual despite being non-diabetic. Post-menopause, the protective effect of estrogen is lost.

How to Approach the Question

First, identify the core concept of the question, which is identifying the group with the highest risk for Coronary Artery Disease (CAD).
Analyze each option by breaking it down into individual risk factors (blood pressure, smoking status, diabetes status, weight, gender).
Recall the major risk factors for CAD: hypertension, smoking, diabetes, obesity, high cholesterol, male gender, increasing age, and family history.
Systematically evaluate each option. Eliminate options containing factors that are not risks for CAD (e.g., hypotension).
Compare the remaining options. The correct answer will be the one that includes the greatest number of potent, cumulative risk factors.
Conclude that the combination of hypertension, smoking, diabetes, obesity, and male gender represents the highest risk profile among the choices.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 506-508

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