What Causes Coronary Microvascular Disease?

The same cluster of risk factors that causes atherosclerosis (ATH-er-o-skler-O-sis) may cause coronary microvascular disease (MVD) in women. Atherosclerosis is when the arteries harden and narrow due to the buildup plaque on their inner walls. It's one of the key causes of heart disease.

Risk factors for atherosclerosis include:

• Unhealthy cholesterol levels. This includes high LDL cholesterol (sometimes called bad cholesterol), low HDL cholesterol (sometimes called good cholesterol), and high triglyerides (another type of fat in the blood).
• 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, increase cholesterol levels, and increase 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 the body convert food to energy.
• 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.
• Lack of physical activity. Lack of activity can worsen other risk factors for atherosclerosis.
• Age. As you get older, your risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build in arteries as you age. By the time you are middle-aged or older, enough plaque has built up to cause signs or symptoms.
  • In men, the risk increases after age 45.
  • In women, the risk increases after age 55.
• Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.

Coronary MVD may be linked to low estrogen levels occurring before or after menopause. It also may be linked to anemia or conditions that affect blood clotting. Anemia is thought to slow the growth of cells needed to repair damaged blood vessels.

It's not yet known whether coronary MVD is the same as MVD linked to other diseases, such as diabetes.