The accumulative effects of modifiable risk factors on inflammation and haemostasis

Various modifiable risk factors have been associated with inflammation and haemostasis, although the accumulative effects have not yet been examined. We therefore explored additive and independent associations of modifiable risk factors (smoking, alcohol, cholesterol, obesity, hypertension, physical activity) with inflammatory (CRP) and haemostatic (fibrinogen) markers. Data were collected from a sample of 7670 healthy asymptomatic participants (45.9% men, aged 46.2 +/- 15.6 years). A graded increase in the risk of inflammation (CRP >= 3 mg/L) with increasing numbers of modifiable risk factors was demonstrated (odds ratio for >= 4 risk factors = 5.09, 95% CI, 3.96-6.55). Similar associations were found in relation to haemostasis. Central adiposity was the strongest independent predictor of inflammation (OR = 3.45, 95% CI, 3.07-3.87) although smoking most strongly predicted haemostasis (OR = 2.19, 95% CI, 1.94-2.48). These findings suggest that targeting multiple risk factors is likely to have the greatest benefit for cardiovascular prevention. (C) 2008 Elsevier Inc. All rights reserved.