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Coronary artery disease (CAD), 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, 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.
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. LDL is also known as the "bad" cholesterol. High density lipoproteins (HDL) carry cholesterol that is being removed from the body, which keeps it from building up on the walls of arteries. HDL is known as the "good" cholesterol.
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 higher will need medication to lower their levels. If you are prescribed medication, take it as directed and report any side effects to you doctor.
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. For healthy adults ages 18 to 65 years, research has shown that 2 hours and 30 minutes or 150 minutes each week of regular moderate-intensity physical activity, such as brisk walking, gardening, or dancing, can help lower your blood pressure. It's important to know you can break up the time into shorter 10-minute periods. Check with your doctor before you start any program to find out which activities and how much activity is safe for you.
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 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.
Lack of exercise is a major risk factor for heart disease because inactivity contributes to higher cholesterol and 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.
Having one or two alcoholic beverages daily may reduce your risk for heart disease. Consuming too much alcohol can raise blood pressure and triglyceride levels and cause other health problems such as cirrhosis, liver cancer, esophageal cancer, and head and neck cancers. The American Heart Association recommends one drink per day for women (one drink equals 12 ounces of beer, or 5 ounces of wine, or 1.5 ounces of 80-proof spirits) and one to two drinks per day for men. It is not recommended that people who do not drink alcohol start drinking. Talk with your healthcare provider for more information.
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 at regular health care visits or at least every two years if blood pressure is less than 120/80, and getting a cholesterol profile every five years for people at normal risk.
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.
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
Difficulty breathing or shortness of breath