2.6 Risk Reduction

Nurses recognize risk factors that increase a client’s risk for injury or disease and then teach methods to reduce risk by behavioral changes. Risk factors for developing disease are classified as modifiable or nonmodifiable. Modifiable risk factors include factors like obesity and smoking and can be reduced by a change in behavior such as healthy diet choices, increased physical activity, and smoking cessation. Nonmodifiable risk factors cannot be changed by the client and include factors such as age, sex, and family history/genetic predisposition. Nurses empower clients to reduce their modifiable risk factors through behavioral change. The following subsections outline modifiable and nonmodifiable risk factors for several common chronic diseases.

Risk Factors for Developing Cardiovascular Disease

Risk factors for developing cardiovascular disease include the following^[1]:

• Modifiable Risk Factors
  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Being overweight or obese
  • Sedentary lifestyle

• Nonmodifiable Risk Factors
  • Family history of early atherosclerotic cardiovascular disease (men less than age 55, women less than age 65)
  • Ethnicity (African American, Hispanic or Latino, and Asian Americans)
  • History of early menopause or preeclampsia

Risk Factors for Type 2 Diabetes

Risk factors for developing type 2 diabetes include the following^[2]:

• Modifiable Risk Factors
  • Having prediabetes
  • Being overweight or obese
  • Sedentary lifestyle
• Nonmodifiable Risk Factors
  • Age 45 or older
  • Family history of type 2 diabetes
  • History of gestational diabetes or having a baby weighing over nine pounds
  • Ethnicity (African American, Hispanic or Latino, American Indian, Alaska Native, some Pacific Islanders, and Asian Americans)

Risk Factors for Developing Metabolic Syndrome

Metabolic syndrome is a group of conditions that increases a person’s risk of coronary heart disease, diabetes, and stroke. The conditions include elevated blood pressure, blood glucose, and triglyceride levels, as well as increased waist circumference. Risk factors for developing metabolic syndrome include the following^[3]:

• Modifiable Risk Factors
  • Sedentary lifestyle
  • Unhealthy diet and large portion sizes
  • Poor quality sleep
  • Cigarette smoking
  • Excess alcohol intake
  • Night shift work

• Nonmodifiable Risk Factors
  • Aging
  • Low socioeconomic status, which affects diet, exercise, and sleep
  • Family history
  • Medical conditions such as obesity, polycystic ovarian syndrome, or sleep apnea
  • Female sex

Risk Factors for Becoming Overweight and Developing Obesity

Risk factors for becoming overweight and developing obesity include the following^[4]:

• Modifiable Risk Factors
  • Sedentary lifestyle
  • Dietary intake of excessive calories, saturated fat, added sugar, and processed foods
  • Poor sleep
  • High stress
  • Health conditions like metabolic syndrome or polycystic ovarian syndrome

• Nonmodifiable Risk Factors
  • Family history
  • Some medications, such as antidepressants
  • Environmental factors, such as green space, safe places to walk, and access to healthy food

Risk Factors for Chronic Obstructive Pulmonary Disease

Risk factors for chronic obstructive pulmonary disease (COPD) include the following^[5]:

• Modifiable Risk Factors
  • Smoking
  • Occupational exposure to fine particulates, such as smoke or dust
  • Smoke exposure from coal or wood burning stove
  • Exposure to secondhand smoke

• Nonmodifiable Risk Factors
  • History of childhood respiratory infections
  • History of asthma
  • Underdeveloped lungs due to premature birth
  • Age over 40
  • Alpha-1 antitrypsin deficiency

Risk Factors for Chronic Kidney Disease

Risk factors for developing chronic kidney disease (CKD) include the following^[6]:

• Modifiable Risk Factors
  • Diabetes
  • High blood pressure
  • Heart disease
  • Obesity
  • Smoking or tobacco use

• Nonmodifiable Risk Factors
  • Ethnicity (African American, Hispanic or Latino, Native American, Asian American)
  • Family history of kidney disease
  • Age over 40
  • Abnormal kidney structure

Risk Factors for Developing Osteoporosis

Risk factors for developing osteoporosis include the following^[7]:

• Modifiable Risk Factors
  • Low estrogen in women due to excess exercising
  • Diet low in calcium, vitamin D, protein, and calories
  • Sedentary lifestyle
  • Chronic excess alcohol intake
  • Smoking

• Nonmodifiable Risk Factors
  • Female sex
  • Aging
  • Slender, thin-boned body frame
  • Caucasian and Asian race
  • Family history of osteoporosis
  • Low estrogen in women due to menopause
  • Low testosterone in men
  • Medical conditions, such as rheumatoid arthritis
  • Medications, such as proton pump inhibitors

Risk Factors for Developing Cancer

Risk factors for developing cancer include the following^[8],[9]:

• Modifiable Risk Factors
  • Exposure to cigarette smoke
  • Ultraviolet (UV) radiation exposure from tanning beds or the sun
  • Overweight or obesity
  • Drinking alcohol
  • Infectious disease exposure, such as human papillomavirus (HPV) or hepatitis B or C

• Nonmodifiable Risk Factors
  • Family history of cancer

Risk Factors for Developing Mental Health Conditions

Risk factors for developing mental health conditions include the following^[10]:

• Modifiable Risk Factors
  • Stressful life events
  • Sedentary lifestyle
  • Parents who misuse drugs, alcohol, or have a mental health condition
  • Adverse childhood events, abuse, or neglect
  • Family dysfunction
  • Neighborhood poverty or violence

• Nonmodifiable Individual Risk Factors
  • Family history of mental health conditions