Which of the following is not a risk factor for coronary heart disease?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Hypotension is the medical term for low blood pressure.
Low blood pressure is not associated with the arterial damage and plaque buildup (atherosclerosis) that characterize coronary heart disease.
The key cardiovascular risk factor related to blood pressure is hypertension (high blood pressure), which accelerates the atherosclerotic process.
Therefore, hypotension is the correct answer as it is not a risk factor for CHD.

Option A: Smoking is a major, modifiable risk factor for CHD. It damages blood vessels, raises blood pressure, and promotes clot formation.
Option B: Oral contraceptives are considered a risk factor, as they can increase blood pressure and the risk of myocardial infarction, especially when combined with other factors like smoking.
Option C: Stress is recognized as a modifiable risk factor for CHD. Chronic stress can contribute to hypertension and unhealthy lifestyle choices.

Clinical Relevance

Nursing practice connection: Knowing Risk factors for Coronary Heart Disease (CHD) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A key nursing role is patient education on modifiable risk factors for CHD. This includes counseling on smoking cessation, diet, exercise, stress management, and adherence to medication for conditions like hypertension and diabetes.
Nurses perform regular screenings for blood pressure and cholesterol to identify individuals at high risk and initiate early interventions.
What if the patient had orthostatic hypotension? While chronic hypotension isn't a CHD risk, orthostatic hypotension (a drop in blood pressure upon standing) is a significant fall risk, especially in older adults. The nursing priority would shift from cardiovascular risk reduction to fall prevention and investigating the underlying cause (e.g., dehydration, medication side effects).

How to Approach the Question

First, identify the keywords in the question stem. Here, the key terms are 'not' and 'risk factor for coronary heart disease'.
The word 'not' indicates this is a negative question. Your goal is to find the option that does not fit with the others.
Review each option and evaluate if it is a known risk factor for CHD.
Option A, Smoking: Recall or verify that this is a major risk factor.
Option B, Oral contraceptives: Recall or verify this is a risk factor, especially in certain populations.
Option C, Stress: Recall or verify this is a recognized risk factor.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 36-38

E6 Nutrition Kumud Khanna 2e p. 291-293

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Attempt every question from this paper in a timed mock, then review the full solution for each one.