Coronary Artery Disease (CAD) and Its Risk Factors

Introduction:

Heart disease is a general term encompassing various conditions affecting the heart. This discussion will focus on Coronary Artery Disease (CAD), the most common type of heart disease in the United States. CAD occurs when the arteries supplying blood to the heart become narrowed or blocked by plaque buildup, a condition known as atherosclerosis. This reduces blood flow to the heart muscle, which can lead to chest pain (angina), heart attack, and heart failure.

Etiology of Coronary Artery Disease:

The exact cause of CAD is complex and involves a combination of factors. However, the buildup of plaque in the coronary arteries (atherosclerosis) is the primary culprit. Plaque consists of fatty deposits (lipids), cholesterol, inflammatory cells, and cellular waste products. Over time, plaque buildup narrows the arteries, hindering blood flow to the heart.

Modifiable Risk Factors:

Several modifiable risk factors contribute to the development and progression of CAD:

• Unhealthy Diet: A diet high in saturated and trans fats, cholesterol, and refined carbohydrates can increase LDL (“bad”) cholesterol and decrease HDL (“good”) cholesterol levels, promoting plaque buildup. (AHA, 2021)
• Physical Inactivity: Lack of regular exercise reduces HDL cholesterol and increases blood pressure, both of which contribute to CAD. (AHA, 2021)
• Smoking: Smoking damages the inner lining of arteries and accelerates atherosclerosis. (AHA, 2021)
• Obesity: Being overweight or obese increases the risk of high blood pressure, diabetes, and unhealthy cholesterol levels, all of which are risk factors for CAD. (NHLBI, 2023)
• Uncontrolled Diabetes: Diabetes can damage blood vessels and contribute to plaque buildup. (AHA, 2021)
• High Blood Pressure: Chronically high blood pressure puts stress on the heart and arteries, increasing the risk of damage and plaque formation. (AHA, 2021)
• Stress: Chronic stress can elevate blood pressure and contribute to unhealthy lifestyle choices that increase CAD risk. (AHA, 2021)

Non-Modifiable Risk Factors:

Certain factors cannot be changed but increase the risk of CAD:

• Age: The risk of CAD increases with age as arteries naturally lose elasticity and become more susceptible to plaque buildup.
• Family History: Having a close relative with CAD increases one’s risk. A family history suggests a potential genetic predisposition.
• Sex: Men are generally at higher risk of CAD than pre-menopausal women. However, women’s risk increases after menopause. (AHA, 2021)