Which individual is at the highest risk for developing coronary artery disease (CAD)?

The individual with the highest risk for developing coronary artery disease (CAD) is the 45-year-old depressed male with a high-stress job. This option highlights several key risk factors that significantly contribute to the development of CAD.

Firstly, depression is associated with an increased risk of heart disease. It can lead to unhealthy lifestyle choices, such as poor diet, lack of exercise, and smoking, and is linked to physiological changes that can adversely affect cardiovascular health. Secondly, the stress from a high-stress job can contribute to the activation of the body's stress response, which may increase blood pressure and heart rate, ultimately placing additional strain on the heart and blood vessels. Chronic stress also influences risk behaviors and could promote the development of atherosclerosis.

Other options present individuals with factors that reduce the risk of CAD or indicate lower overall cardiovascular risk. The 60-year-old male with below normal homocysteine levels has a favorable marker, as elevated homocysteine is associated with increased risk of heart disease. The 54-year-old female vegetarian with elevated HDL levels is likely benefiting from her diet, which is often heart-healthy, as HDL is known as "good" cholesterol that helps to remove other forms of cholesterol from the bloodstream. The