What You Need to Know About Coronary Artery Disease

Coronary artery disease, also called coronary heart disease, is primarily caused by atherosclerosis, a process in which a substance called plaque builds up on the inner walls of the arteries. When the buildup occurs in the coronary arteries, the arteries that supply the heart, it causes CAD.

Plaque is made up of fat, cholesterol, calcium and other substances found in the blood. Eventually, the build up of plaque narrows and hardens the arteries, and blood flow to the heart is reduced. This decreases the oxygen supply to the heart muscle.

When the heart muscle does not get enough oxygen, two conditions can develop, angina and a heart attack. Angina is a condition in which the heart muscle does not get sufficient oxygen. This causes chest pain or discomfort. A heart attack can occur if an artery closes all the way or a clot blocks the blood flow. When this happens, the heart muscle does not get oxygen and cells begin to die. A blocked coronary artery can also cause an irregular heart beat called arrhythmia that decreases the heart’s ability to pump blood and can cause death.

Certain factors increase your risk of developing CAD. According to the National Heart, Lung and Blood Institute (NHLBI), some risk factors can't be changed:

• Your age. Men older than 45 and women older than 55 are at higher risk.

• Having a family history of early heart disease. Your risk increases if heart disease was diagnosed in your father or brother before age 55, or if heart disease was diagnosed in your mother or sister before age 65.

But you can control other factors.

High cholesterol

Cholesterol is a waxy substance your body needs for nerve function, and to make cells and hormones. It is found naturally in foods and is made by your body. It is carried in the blood in combination with other substances called lipoproteins. Low density lipoproteins (LDL) carry the form of cholesterol that builds up in the arteries. High density lipoproteins (HDL) carry cholesterol that is being removed from the body, which keeps it from building up on the walls of arteries.

A low HDL level (less than 40 mg/dL in men; less than 50 mg/dL in women) increases the risk for heart disease. If you have too much LDL cholesterol (160mg/dL or higher), it can accumulate with other substances in the lining of the arteries. This makes the arteries narrower and eventually blocks the flow of blood. 

Two ways to lower your cholesterol without medication are to exercise regularly and eat a diet low in saturated fat and low in cholesterol. Most people with a total cholesterol of 240 mg/dL or high will need medication to lower their levels. If you are prescribed medication, take it as directed and report any side effects to you doctor.

High blood pressure

Your heart works harder when your blood pressure is at 140/90 mm Hg or greater. This level is called high blood pressure. When your blood pressure is high for an extended time, the heart can enlarge and arteries can become scarred and hardened. You can treat high blood pressure with medication and by making changes in your diet, weight and exercise routine.

Cigarette smoking

Smoking has been identified as the single most important modifiable risk factor for heart disease. Smoking promotes heart disease by speeding up the development of atherosclerosis and reducing your HDL cholesterol.

Diabetes

Diabetes makes it easier for plaque to form in your arteries. Because of this, it increases the risk for heart attack. People with diabetes are two to four times as likely to have a heart attack as is someone who does not have diabetes. You can delay or prevent the buildup of plaque by keeping blood sugar levels in the optimal range, and managing high blood pressure, cholesterol and weight.

Physical inactivity

Lack of exercise is a major risk factor for heart disease because inactivity contributes to higher cholesterol and obesity.

Obesity

Your risk of heart disease increases if you're more than 30 percent overweight. Obesity raises cholesterol and blood pressure, and can lead to diabetes, another risk factor for heart disease. You can reduce your risk for heart disease by losing as few as 10 pounds if you are overweight.

Alcohol

Having one or two alcoholic beverages daily may reduce your risk for heart disease. Consuming more than one drink a day if you are a woman or a man older than 65, or more than two drinks a day if you are a man younger than 65, can raise blood pressure and triglyceride levels and cause other health problems such as cirrhosis, liver cancer, esophageal cancer, and head and neck cancers.

Preventing heart disease

You can reduce your risk for heart disease and a heart attack by seeing your doctor for regular checkups to evaluate your risk factors. If you have risk factors, you and your doctor can work together to control them.

The American Heart Association recommends regular screening for risk factors beginning at age 20. Screening includes measuring blood pressure, body mass index, waist circumference and pulse every two years, and getting a cholesterol profile and glucose test (a simple blood sugar test) every five years.

Your doctor may want you to have more frequent screenings or visits if you have a family history of heart disease, diabetes, high blood pressure, high cholesterol or other health problems.

Signs of a heart attack

If you or someone you're with is having a heart attack, call 911 or your emergency medical help number. While waiting for emergency help to arrive, give the person a whole adult aspirin tablet if he or she is able to swallow and is not allergic to aspirin.

These are signs of a heart attack:

• Pain, pressure or a squeezing in the middle of the chest that lasts for more than a few  minutes

• Pain that spreads from the chest to the shoulders, neck, jaw or arms

• Dizziness or faint feeling

• Nausea

• Sweating

• Difficulty breathing or shortness of breath

• Irregular heartbeat