Which of the following is/are true with respect to risk factors for atherosclerosis?

a. Risk factors are categorized as behavioral or metabolic

c. Personal behaviors that increase cardiovascular risk do so by modifying metabolic parameters

d. The two primary behaviors that increase risk of atherosclerosis are consuming a diet high in animal fat and smoking cigarettes 

The term risk factor was first introduced in reports from the Framingham study in 1961. Risk factors are generally characterized as behavioral or metabolic. Far and away the two greatest risks are consuming a diet high in animal fat and smoking cigarettes. Other factors, such as a sedentary life style, aggressive high stress (Type A) behavior and alcohol use are much less clear. The metabolic traits are primarily hyperlipidemia, hypertension, diabetes, and homocystinemia. Neither the metabolic or the behavioral factors appear to have a threshold effect, rather there is a progressive increase in the incidence of coronary heart disease with each level of hypertension, plasma cholesterol and number of cigarettes smoked. With the exception of cigarette smoking which directly injures the arterial wall, personal behaviors that increase cardiovascular risk seem to do so by modifying metabolic parameters. Increased physical activity may decrease the risk by improving the resting blood pressure and lipid profiles. Likewise a reduction in Type A behavior may reduce blood pressure. Finally, dietary modification may result in significant changes in total plasma cholesterol, LDL and HDL.