Coronary Artery Disease Risk

Last Updated: May 3, 2022

Coronary artery disease (CAD; sometimes called coronary heart disease, or CHD) is a common kind of heart disease caused by atherosclerosis of the heart’s arteries. Diet and exercise can play a pretty big role to both prevent and treat it. High blood pressure and high cholesterol are two major risk factors.

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What is coronary artery disease?

Coronary artery disease (CAD; sometimes called coronary heart disease, or CHD) is the most common kind of heart disease. It happens when the arteries that feed blood to the heart muscles harden and get clogged through atherosclerosis. This process starves the heart of the oxygen and nutrients it needs to function well. Worsening CAD can lead to permanent heart damage and ultimately death. [1]

What are the main signs and symptoms of coronary artery disease?

Damage to the coronary begins early in life, and is usually without major symptoms until things get pretty bad. At that point, one of the main symptoms of CAD is chest pain (angina) that lasts on the order of minutes (as opposed to hours or seconds)[2]. However, the specifics of how this feels, when it occurs, and what’s associated with the pain depend on the specifics of the clinical disease; heart attacks (where a clot breaks off from a ruptured athrosclerotic plaque and blocks a narrower downstream artery) are different from, say, stable ischemic heart disease (where pain appears upon exertion and settles down afterwards).

How is coronary artery disease diagnosed?

The specifics of how chest pain feels, along with risk factors such as high cholesterol, high blood pressure, diabetes, lifestyle factors such as smoking, and a family history of cardiovascular diseases is often enough to raise a strong suspicion of CAD. Physical examination and additional testing by a medical professional along with results along with blood work can provide further evidence.[3]

What are some of the main medical treatments for coronary artery disease?

The specifics of medical treatment ultimately depends on the specifics of the person and the clinical disease they have. The treatments tend to fall into a few categories:

  • Medically treating underlying risk factors to slow CAD progression. For instance, statins can be used to lower cholesterol - and prevent further heart damage
  • Drugs for symptom relief. For example, nitroglycerin can be used in people with stable ischemic heart disease to reduce short-term chest pain. Drugs that work on the heart like beta-blockers and calcium-channel blockers are often used to control pain and discomfort in the longer term, and also may help improve other outcomes in people who have established clinical disease[3]
  • In severe cases, invasive procedures like surgeries are sometimes used

Medical treatments are ideally added on top of lifestyle changes that can help slow CAD progression. Things like quitting smoking and exercise can help a lot.

Have any supplements been studied for coronary artery disease?

Yes, many supplements have been studied for both preventing clinical CAD as well as in people who already have CAD.[4] Given that high blood pressure and high cholesterol cause CAD, supplements that affect those outcomes may also affect the risk of CAD progression.

What's the connection between diet and coronary artery disease?

There’s a big connection, although there’s still some controversy around the details, such as whether or not limiting saturated fat without considering what it’s being replaced with will do much.[5][6][7] Just like with atherosclerosis, guidelines suggest that a diet abundant in vegetables, fruits, legumes, nuts, whole grains, can help reduce the risk of CAD.[8] Weight loss for people with higher BMIs may also play a role in preventing CAD, although the current evidence suggests that modest weight loss (in the 5-10 kg range) may have limited benefits.[9]

Are there any other treatments for coronary artery disease?

Exercise can play a big role in preventing CAD[8] and also can help people who have CAD improve their health.[10] Guidelines suggest that the role of resistance training in preventing CAD is unclear, but resistance training is still encouraged.[8]

What causes coronary artery disease?

Atherosclerosis of the coronary arteries leads to CAD.

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  1. ^MedlinePlus: Coronary artery disease
  2. ^Essential Evidence Plus: Coronary Heart Disease: Diagnosis. Last updated 12/13/19. Accessed 4/28/22.
  3. ^Juhani Knuuti, William Wijns, Antti Saraste, Davide Capodanno, Emanuele Barbato, Christian Funck-Brentano, Eva Prescott, Robert F Storey, Christi Deaton, Thomas Cuisset, Stefan Agewall, Kenneth Dickstein, Thor Edvardsen, Javier Escaned, Bernard J Gersh, Pavel Svitil, Martine Gilard, David Hasdai, Robert Hatala, Felix Mahfoud, Josep Masip, Claudio Muneretto, Marco Valgimigli, Stephan Achenbach, Jeroen J Bax, ESC Scientific Document Group2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromesEur Heart J.(2020 Jan 14)
  4. ^Jeffrey Knox, Barak GasterDietary supplements for the prevention and treatment of coronary artery diseaseJ Altern Complement Med.(Jan-Feb 2007)
  5. ^Arne Astrup, Faidon Magkos, Dennis M Bier, J Thomas Brenna, Marcia C de Oliveira Otto, James O Hill, Janet C King, Andrew Mente, Jose M Ordovas, Jeff S Volek, Salim Yusuf, Ronald M KraussSaturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art ReviewJ Am Coll Cardiol.(2020 Aug 18)
  6. ^Penny M Kris-Etherton, Ronald M KraussPublic health guidelines should recommend reducing saturated fat consumption as much as possible: YESAm J Clin Nutr.(2020 Jul 1)
  7. ^Lee Hooper, Nicole Martin, Oluseyi F Jimoh, Christian Kirk, Eve Foster, Asmaa S AbdelhamidReduction in saturated fat intake for cardiovascular diseaseCochrane Database Syst Rev.(2020 May 19)
  8. ^Donna K Arnett, Roger S Blumenthal, Michelle A Albert, Andrew B Buroker, Zachary D Goldberger, Ellen J Hahn, Cheryl Dennison Himmelfarb, Amit Khera, Donald Lloyd-Jones, J William McEvoy, Erin D Michos, Michael D Miedema, Daniel Muñoz, Sidney C Smith Jr, Salim S Virani, Kim A Williams Sr, Joseph Yeboah, Boback Ziaeian2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice GuidelinesCirculation.(2019 Sep 10)
  9. ^Tiffany M Powell-Wiley, Paul Poirier, Lora E Burke, Jean-Pierre Després, Penny Gordon-Larsen, Carl J Lavie, Scott A Lear, Chiadi E Ndumele, Ian J Neeland, Prashanthan Sanders, Marie-Pierre St-Onge, American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke CouncilObesity and Cardiovascular Disease: A Scientific Statement From the American Heart AssociationCirculation.(2021 May 25)
  10. ^Grace Dibben, James Faulkner, Neil Oldridge, Karen Rees, David R Thompson, Ann-Dorthe Zwisler, Rod S TaylorExercise-based cardiac rehabilitation for coronary heart diseaseCochrane Database Syst Rev.(2021 Nov 6)
Examine Database References
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  2. Black Cohosh - Michael Bebenek, Wolfgang Kemmler, Simon von Stengel, Klaus Engelke, Willi A KalenderEffect of exercise and Cimicifuga racemosa (CR BNO 1055) on bone mineral density, 10-year coronary heart disease risk, and menopausal complaints: the randomized controlled Training and Cimicifuga racemosa Erlangen (TRACE) studyMenopause.(2010 Jul)
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