Problem: George Jones is a 59-year-old male who has arrived at the emergency department with chest pain. He had experienced this chest pain for 30 minutes, and it was not relieved after taking four nitroglycerin tablets 5 minutes apart. He reports the pain feels "like an elephant is sitting on my chest." He is diaphoretic and appears anxious. His vital signs are as follows: temperature, 99°F; blood pressure, 100/68 mm Hg; heart rate, 110 beats/min; and respiratory rate, 24 breaths per minute. Mr. Jones is overweight and has type 2 diabetes mellitus, hyperlipidemia, and hypertension. He quit smoking last year after a 40-year history of smoking one pack of cigarettes a day. His troponin level is elevated, and the ECG shows ST segment elevation. The nurse administers oxygen and draws blood for arterial blood gas analysis. Mr. Jones is told he will have a cardiac catheterization to locate the blockage, determine its severity, and evaluate left ventricular function. 1. What risk factors does Mr. Jones have for impaired perfusion?