Who Is At Risk for Coronary Artery Disease?

Coronary artery disease (CAD) is the leading cause of death in the United States for both men and women. Each year, more than half a million Americans die from CAD.

Certain traits, conditions, or habits may raise your chance of developing CAD. These conditions are known as risk factors.

You can control most risk factors and help prevent or delay CAD. Other risk factors can't be controlled.

Major Risk Factors

Many factors raise the risk of developing CAD. The more risk factors you have, the greater chance you have of developing CAD.

• Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called bad cholesterol) and low HDL cholesterol (sometimes called good cholesterol).
• High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over a period of time.
• Smoking. This can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn't allow enough oxygen to reach the body's tissues.
• Insulin resistance. This condition occurs when the body can't use its own insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used.
• Diabetes. This is a disease in which the body's blood sugar level is high because the body doesn't make enough insulin or doesn't use its insulin properly.
• Overweight or obesity. Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat.
• Metabolic syndrome. Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity that raise your chance for heart disease and other health problems, such as diabetes and stroke.
• Lack of physical activity. Lack of activity can worsen other risk factors for CAD.
• Age. As you get older, your risk for CAD increases. Genetic or lifestyle factors cause plaque to build in your arteries as you age. By the time you're middle-aged or older, enough plaque has built up to cause signs or symptoms.
  • In men, the risk for CAD increases after age 45.
  • In women, the risk for CAD risk increases after age 55.
• Family history of early heart disease. Your risk increases if your father or a brother was diagnosed with CAD before 55 years of age, or if your mother or a sister was diagnosed with CAD before 65 years of age.

Although age and a family history of early heart disease are risk factors, it doesn't mean that you will develop CAD if you have one or both.

Making lifestyle changes and/or taking medicines to treat other risk factors can often lessen genetic influences and prevent CAD from developing, even in older adults.

Emerging Risk Factors

Scientists continue to study other possible risk factors for CAD.

High levels of a protein called C-reactive protein (CRP) in the blood may raise the risk for CAD and heart attack. High levels of CRP are proof of inflammation in the body. Inflammation is the body's response to injury or infection. Damage to the arteries' inner walls seems to trigger inflammation and help plaque grow.

Research is under way to find out whether reducing inflammation and lowering CRP levels also can reduce the risk of developing CAD and having a heart attack.

High levels of fats called triglycerides in the blood also may raise the risk of CAD, particularly in women.

Other Factors That Affect Coronary Artery Disease

Other factors also may contribute to CAD. These include:

• Sleep apnea. Sleep apnea is a disorder in which your breathing stops or gets very shallow while you're sleeping. Untreated sleep apnea can raise your chances of having high blood pressure, diabetes, and even a heart attack or stroke.
• Stress. Research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event—particularly one involving anger.
• Alcohol. Heavy drinking can damage the heart muscle and worsen other risk factors for heart disease. Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day.