What Is Coronary Artery Disease (CAD)?

Coronary artery disease (CAD) is a medical term for the most common type of heart disease. It is the leading cause of death in the United States and around the world.^1-3 CAD develops when fat and cholesterol deposits, called plaque, build up in the arteries. This makes the arteries more narrow and the blood vessel walls thicker and less flexible.^3-4

What causes coronary artery disease?

The buildup of plaque is called atherosclerosis or hardening of the arteries. Atherosclerosis usually develops over time; however, it can happen quickly and unexpectedly if a blood clot breaks away and blocks an artery.⁴ Atherosclerosis reduces the amount of blood flow so there are fewer nutrients and oxygen to sustain the body.

Coronary artery disease is sometimes called ischemia, which means inadequate blood flow.⁵ When plaque builds up in arteries that supply blood to the heart, less blood reaches the heart muscle. This can trigger symptoms such as chest pain or pressure (angina). It can also play a role in high blood pressure. CAD can cause a heart attack if an artery becomes completely blocked and no blood can get through to feed the heart.³ CAD can lead to heart failure and heart rhythm problems called arrhythmias. If this happens, the heart is unable to pump blood the way that it should because the heart muscle gets weak.⁴

How is coronary artery disease diagnosed?

Regular health checkups generally include an evaluation of your heart and your risk for heart disease. From the time you are young, your doctor may measure blood pressure, cholesterol, weight, and sometimes sugar levels. Children who are overweight, inactive, or have poor eating habits are at risk of developing CAD. A family history of heart disease or being a smoker also increases your risk.⁴ What you eat and your physical activity level in childhood can influence whether you develop plaque deposits. These can be seen early on in life.^5-6 Doctors often recommend steps to achieve a healthy lifestyle to prevent or delay the onset of CAD.⁵

What are the risk factors for coronary artery disease?

Coronary artery disease develops due to a mix of lifestyle, environment, and genetics.¹ Some of these risks can be controlled such as diet and exercise. Risk factors that cannot be controlled include age, gender, race, and genetics. Post-menopausal women and men over age 45 have increased risk.^3,5,6

The main risk factors for CAD include cholesterol levels, high blood pressure, family history, diabetes, obesity, and stress. Cholesterol is a type of fat in the blood. It is made up of low-density lipoprotein (LDL) or “bad cholesterol” and high-density lipoproteins (HDL), or “good cholesterol.” High levels of LDL and low levels of HDL can lead to CAD. Higher levels of HDL are thought to protect the heart because it carries cholesterol to the liver where it is removed from the body.⁶

What are the symptoms of coronary artery disease?

As coronary arteries narrow from plaque buildup, the oxygen-rich blood supply to the heart decreases.⁶ In the beginning, you may not notice any symptoms. However, as CAD progresses, you may feel symptoms when you are active, and your heart is working harder. Symptoms may include chest pain, shortness of breath, and a heart attack.

How is coronary artery disease treated?

Many different kind of drugs may be prescribed to treat CAD. The drugs your doctor prescribes will depend on whether you need to be treated for high cholesterol, high blood pressure, irregular heartbeat, or decreased blood flow. Surgery may be needed when blood vessels to the heart become blocked.⁸ Catheter-based techniques include angioplasty and stent placement. Other surgery includes coronary artery bypass graft (CABG) surgery.⁷

Can coronary artery disease be prevented?

Like other kinds of heart disease, CAD may be prevented or delayed with diet and exercise and lifestyle changes.³ There are steps everyone can take to help lower their risk for most kinds of heart disease, including:⁷

• Eating a heart-healthy diet
• Increasing physical activity to a minimum of 30 minutes a day
• Keeping any high blood pressure and diabetes under control
• Not smoking, or quit smoking
• Managing stress