The INTERHEART study — a large multinational case-control study on acute myocardial infarction — identified which combination of factors as accounting for over 90% of the population-attributable risk for AMI globally?
- A Smoking, diabetes, hypertension, and dyslipidaemia
- B Nine modifiable risk factors including smoking, dyslipidaemia, hypertension, diabetes, abdominal obesity, diet, physical inactivity, alcohol consumption, and psychosocial factors ✓
- C Age, male sex, family history, smoking, and dyslipidaemia
- D Hypertension, diabetes, smoking, and sedentary lifestyle
Explanation
The INTERHEART study (Yusuf et al., Lancet 2004), conducted in 52 countries with 15,000 AMI cases and 15,000 controls, demonstrated that nine modifiable risk factors — smoking, abnormal lipids (ApoB/ApoA1 ratio), hypertension, diabetes, abdominal obesity, psychosocial factors, daily consumption of fruits and vegetables, physical activity, and alcohol — together accounted for over 90% of the population-attributable risk for first AMI in all geographic regions, ethnicities, and sex. This landmark study established the universality of modifiable risk factors across cultures. Age, male sex, and family history (option C) are non-modifiable risk factors not assessed in the same framework.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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