The nurse is instructing a community group regarding risk factors for coronary artery disease. Which risk factor cannot be modified?

Choice A rationale Cigarette smoking is considered a major modifiable risk factor for coronary artery disease (CAD). The chemicals in tobacco smoke damage the endothelium, promote vasoconstriction, and increase low-density lipoprotein (LDL) cholesterol, all of which accelerate the development of atherosclerosis, but this risk can be mitigated by cessation. Choice B rationale Hypertension, defined as a persistent blood pressure of 130/80 mmHg or higher, is a major modifiable risk factor. Chronically elevated pressure causes mechanical stress and injury to the arterial walls, promoting plaque formation and increasing the risk of CAD, but it can be controlled through diet, exercise, and medication. Choice C rationale Heredity, or a family history of premature CAD (definite myocardial infarction or sudden death before age 55 in the father or other first-degree male relative, or before age 65 in the mother or other first-degree female relative), is a non-modifiable risk factor because a person cannot change their genetic makeup or family history. Choice D rationale Diabetes mellitus is a significant modifiable risk factor for CAD because chronic hyperglycemia promotes inflammation and vascular damage, accelerating atherosclerosis. However, the progression of vascular damage can be substantially slowed or managed through strict blood glucose control, diet, exercise, and medication.