Prevalence of Coronary Heart Disease Risk Factors in Acute Coronary Syndrome: A Gender-Based Comparison in Punjab, Pakistan
Abstract
Objective: To estimate the prevalence of coronary heart disease (CHD) risk factors among patients presenting with acute coronary syndrome (ACS) and to compare these risk factors by gender. Methods: A hospital-based cross-sectional study was conducted at the Punjab Institute of Cardiology, Lahore. A total sample of 120 adult patients (age 23–80 years) with a clinician-confirmed diagnosis of ACS (based on clinical assessment, ECG changes, and cardiac enzyme assays) were consecutively enrolled. Comatose and critically ill patients were excluded. Data on demographics, ACS subtype, symptom profile, and standard cardiovascular risk factors were collected and analyzed in SPSS v25.0. Gender-based comparisons used chi-square or t-tests; significance was set at p<0.05. Results: Of 120 ACS patients, myocardial infarction was more prevalent in men than women (88.5% vs. 71.4%, p = 0.015), while unstable angina was more frequent in women (28.6% vs. 11.5%, p = 0.015); atypical presentation was also higher in women (38.1% vs. 21.8%, p = 0.018). Regarding risk factors, hypertension (71.4% vs. 53.8%, p = 0.046), obesity (73.8% vs. 44.9%, p = 0.002), and diabetes (52.4% vs. 33.3%, p = 0.040) were significantly higher in women, whereas smoking (60.3% vs. 7.1%, p < 0.001) and physical inactivity (64.1% vs. 42.9%, p = 0.022) were significantly higher in men; clustering of ≥3 risk factors was more common in women (83.3% vs. 65.4%, p = 0.032). Conclusion: In this single-center cohort from Punjab, Pakistan, women with ACS presented at a younger age, more frequently with unstable angina and atypical symptoms, and carried higher rates of hypertension and obesity. Men had greater prevalence of smoking and physical inactivity. Nearly all patients had at least one modifiable risk factor, and risk-factor clustering was common—especially among women—highlighting the need for gender-sensitive prevention and early detection strategies.
Keywords: Risk Factors; Coronary Heart Disease; Acute Coronary Syndrome; STEMI; NSTEMI; Unstable Angina; Gender Differences
