Impact of Metabolic Risk Factors on the Progression of Coronary Heart Disease: A Retrospective Cohort Study in Indonesia
DOI:
https://doi.org/10.32628/IJSRSET25122158Keywords:
Cox proportional hazards, Coronary heart disease, Hypertension, Metabolic risk factors, DyslipidemiaAbstract
Coronary Heart Disease (CHD) remains a significant global health issue, with its progression closely tied to metabolic risk factors, including dyslipidemia, hypertension, and diabetes. This study utilized secondary data from the Indonesia Ministry of Health's Cohort Study on Non-Communicable Disease (NCD) Risk Factors, spanning from 2011 to 2019, to examine the relationship between metabolic factors and CHD onset. Using the Cox Proportional Hazards (CPH) model, the study assessed the hazard ratios (HR) of key factors such as blood sugar, cholesterol, LDL, HDL, and blood pressure. The results showed that high blood sugar (HR = 1.93, p = 0.000), high cholesterol (HR = 2.68, p = 0.000), and high LDL (HR = 5.87, p = 0.000) were significant risk factors for CHD. Conversely, high HDL (HR = 1.66, p = 0.000) demonstrated a protective effect, while high blood pressure (HR = 6.85, p = 0.000) had the strongest association with disease progression. Kaplan-Meier survival curves further illustrated the decline in survival probabilities with increasing levels of these risk factors. These findings underscore the importance of managing metabolic risk factors to prevent and manage CHD.
Downloads
References
G. A. Roth et al., “Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study,” J. Am. Coll. Cardiol., vol. 76, no. 25, p. 2982, Dec. 2020, doi: 10.1016/J.JACC.2020.11.010.
F. R. Muharram et al., “The 30 Years of Shifting in The Indonesian Cardiovascular Burden—Analysis of The Global Burden of Disease Study,” J. Epidemiol. Glob. Health, vol. 14, no. 1, pp. 193–212, 2024, doi: 10.1007/s44197-024-00187-8.
M. Gaggini, F. Gorini, and C. Vassalle, “Lipids in Atherosclerosis: Pathophysiology and the Role of Calculated Lipid Indices in Assessing Cardiovascular Risk in Patients with Hyperlipidemia,” Int. J. Mol. Sci., vol. 24, no. 1, 2023, doi: 10.3390/ijms24010075.
V. Blaton, “How Is The Metabolic Syndrome Related to the Dyslipidemia ?,” Jiffc, vol. 18, pp. 15–22, 2007.
Z. Du and Y. Qin, “Dyslipidemia and Cardiovascular Disease: Current Knowledge, Existing Challenges, and New Opportunities for Management Strategies,” J. Clin. Med., vol. 12, no. 1, pp. 12–15, 2023, doi: 10.3390/jcm12010363.
T. Sugiura et al., “Impact of lipid profile and high blood pressure on endothelial damage.,” J. Clin. Lipidol., vol. 5, no. 6, pp. 460–466, 2011, doi: 10.1016/j.jacl.2011.06.005.
E. H. Herningtyas and T. S. Ng, “Prevalence and distribution of metabolic syndrome and its components among provinces and ethnic groups in Indonesia,” BMC Public Health, vol. 19, no. 1, pp. 1–12, 2019, doi: 10.1186/s12889-019-6711-7.
E. Dal Canto et al., “Diabetes as a cardiovascular risk factor: An overview of global trends of macro and micro vascular complications.,” Eur. J. Prev. Cardiol., vol. 26, no. 2_suppl, pp. 25–32, Dec. 2019, doi: 10.1177/2047487319878371.
S. K. Lwanga and S. Lemeshow, “Sample size determination in health studies : a practical manual.” Accessed: Mar. 09, 2025. [Online]. Available: https://iris.who.int/handle/10665/40062
D. G. K. Klein, Statistics for Biology and Health. 2010.
G. Fahed et al., “Metabolic Syndrome: Updates on Pathophysiology and Management in 2021,” Int. J. Mol. Sci., vol. 23, no. 2, 2022, doi: 10.3390/ijms23020786.
S. M. Grundy et al., “Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute scientific statement,” Circulation, vol. 112, no. 17, pp. 2735–2752, 2005, doi: 10.1161/CIRCULATIONAHA.105.169404.
H. A. R. Hadi and J. A. Al Suwaidi, “Endothelial dysfunction in diabetes mellitus,” Vasc. Health Risk Manag., vol. 3, no. 6, pp. 853–876, 2007.
P. Das and N. Ingole, “Lipoproteins and Their Effects on the Cardiovascular System,” Cureus, vol. 15, no. 11, 2023, doi: 10.7759/cureus.48865.
M. F. Linton et al., “The Role of Lipids and Lipoproteins in Atherosclerosis,” Science (80-. )., vol. 111, no. 2877, pp. 166–186, Jan. 2019, Accessed: Mar. 22, 2025. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK343489/
S. K. Masenga and A. Kirabo, “Hypertensive heart disease: risk factors, complications and mechanisms,” Front. Cardiovasc. Med., vol. 10, no. June, pp. 1–16, 2023, doi: 10.3389/fcvm.2023.1205475.
J. Shreffler and M. R. Huecker, “Hypothesis Testing, P Values, Confidence Intervals, and Significance,” StatPearls, Mar. 2023, Accessed: Mar. 23, 2025. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK557421/
Z. Wang, J. Chen, L. Zhu, S. Jiao, Y. Chen, and Y. Sun, “Metabolic disorders and risk of cardiovascular diseases: a two-sample mendelian randomization study,” BMC Cardiovasc. Disord., vol. 23, no. 1, pp. 1–8, 2023, doi: 10.1186/s12872-023-03567-3.
D. Aronson and E. J. Rayfield, “How hyperglycemia promotes atherosclerosis: Molecular mechanisms,” Cardiovasc. Diabetol., vol. 1, pp. 1–10, 2002, doi: 10.1186/1475-2840-1-1.
K. Malekmohammad, E. E. Bezsonov, and M. Rafieian-Kopaei, “Role of Lipid Accumulation and Inflammation in Atherosclerosis: Focus on Molecular and Cellular Mechanisms.,” Front. Cardiovasc. Med., vol. 8, p. 707529, 2021, doi: 10.3389/fcvm.2021.707529.
L. Mykkänen, J. Kuusisto, S. M. Haffner, M. Laakso, and M. A. Austin, “LDL Size and Risk of Coronary Heart Disease in Elderly Men and Women,” Arterioscler. Thromb. Vasc. Biol., vol. 19, no. 11, pp. 2742–2748, Nov. 1999, doi: 10.1161/01.ATV.19.11.2742.
M. Casula, O. Colpani, S. Xie, A. L. Catapano, and A. Baragetti, “HDL in atherosclerotic cardiovascular disease: In search of a role,” Cells, vol. 10, no. 8, pp. 1–17, 2021, doi: 10.3390/cells10081869.
W. Hollander, “Role of hypertension in atherosclerosis and cardiovascular disease,” Am. J. Cardiol., vol. 38, no. 6, pp. 786–800, 1976, doi: https://doi.org/10.1016/0002-9149(76)90357-X.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 International Journal of Scientific Research in Science, Engineering and Technology

This work is licensed under a Creative Commons Attribution 4.0 International License.