Although hypertension does represent a significant risk factor for coronary heart disease, it does not have a direct visual manifestation like the corneal arcus seen in this patient's eye image.

The image reveals a corneal arcus, which is a ring around the cornea that can be a manifestation of hypercholesterolemia. The patient's age and presentation, combined with this sign, raise suspicion of familial hypercholesterolemia, which can increase the risk of coronary artery disease.

While habitual smoking is a risk factor for coronary heart disease, it would not cause a corneal arcus.

Although obesity is a risk factor for cardiovascular disease, the specific finding of corneal arcus is not associated with obesity.