Heart disease is the leading cause of death for both men and women. Coronary artery disease (CAD) is the most common type of heart disease. According to the Centers for Disease Control and Prevention (CDC), more than 370,000 people die from CAD each year in the United States. The most common cause of CAD is plaque buildup in the coronary arteries.
Many factors can increase your risk of developing CAD. You can control some of these factors. Read more about the risk factors.
Risk factors you can’t control
It's important to be aware of risk factors you can’t control because you may be able to monitor their effects.
Age and gender
Your risk of CAD increases as you age because plaque builds up over time. The risk for women increases at age 55. The risk for men increases at age 45.
CAD is the most common kind of heart disease among both men and women in the United States. White men between the ages of 35 and 44 are about 6 times more likely to die of CAD than white women in that same age group. This difference between men and women is different among nonwhites. The death rate among women increases after menopause. A woman’s risk of death from CAD is equal to or greater than the risk for a man by age 75.
Some degree of CAD often occurs as people age, with the condition identifiable in more than 80 percent of adults over age 80. Changes that occur in the body as you age create conditions that make it easy for heart disease to develop. For example, the smooth artery vessel walls can naturally develop rough surfaces that attract plaque deposits.
In the United States, heart disease is the leading cause of death for most ethnicities. According to the CDC, heart disease is second only to cancer as a cause of death among:
- American Indians
- Alaska Natives
- Pacific Islanders
The risk of heart disease is higher than for some ethnicities than others. According to the U.S. Department of Health and Human Services Office of Minority Health (OMH), African-American men and women in the United States were 30 percent more likely to die of heart disease, including CAD, than non-Hispanic white men and women in 2010. White men and women have a significantly higher rate of death from heart disease than American Indians and Alaska Natives, according to the OMH.
The increased risk of heart disease in some ethnicities is associated with increased rates of high blood pressure, obesity, and diabetes.
Heart disease may run in the family. According to the World Heart Federation, your heart disease risk increases if a close family member has heart disease. Your risk is highest if your father or a brother was diagnosed with heart disease before age 55, or if your mother or a sister was diagnosed before age 65. You may also inherit type 1 diabetes, or some other disease or trait that increases your risk of CAD.
Risk factors you can control
Many risk factors for CAD are controllable. According to the American Heart Association (AHA), you can change six major risk factors:
Even if you have no other risk factors, smoking, by itself, increases your risk of CAD. If you have coexisting risk factors, your CAD risk rises exponentially. It's especially dangerous to smoke if you have a family history of heart disease or if you take birth control pills.
High LDL cholesterol, known as bad cholesterol, and low HDL cholesterol, known as good cholesterol, are factors that can indicate a serious risk for CAD. High levels of LDL and low levels of HDL increase your risk of plaque building up in your arteries.
The National Heart, Lung, and Blood Institute (NHLBI) suggests an easy way to remember which cholesterol is good and which is bad. When you hear the “L” in LDL, think “lousy” and “lower.” When you hear the “H” in HDL, think “healthy” and “higher.”
According to the NHLBI, your LDL reading should be less than 100 milligrams per deciliter (mg/dL). Your HDL cholesterol level should be at least 40 mg/dL. You should also keep an eye on your triglycerides, a type of fat circulating in your blood. Your triglyceride level should stay below 150 mg/dL. The amount of triglyceride is related to sugar intake. You can reduce your triglycerides by reducing your intake of sugary substances.
High blood pressure
Blood pressure is a measurement of how much resistance the vessels offer as your heart pumps blood through them. Over time, high blood pressure can cause the coronary arteries to narrow and stiffen. You should aim to keep your blood pressure consistently at or below 120/88 mm Hg. However, according to the AHA, one-third of American adults have high blood pressure. High blood pressure is defined as 140/90 mm Hg. If you have high blood pressure, the AHA recommends that you start with some lifestyle changes that can help lower it. This can include:
- losing weight
- exercising regularly
- limiting the amount of alcohol you consume
- eating a healthy diet
- managing stress
If these lifestyle changes don’t lower your high blood pressure to the recommended range, you and your doctor may want to discuss medications that can help lower your blood pressure.
Exercise helps lower your risk of CAD by lowering blood pressure, raising HDL cholesterol, and strengthening your heart, so it works more efficiently. It also helps you maintain a healthy weight and reduces your risk for other diseases, such as obesity and diabetes, which might lead to CAD.
Being overweight or obese
Being overweight or obese increases your risk of CAD dramatically. Carrying too much weight is often associated with high blood pressure or diabetes, and it’s directly related to poor diet and physical activity habits.
Being overweight or obese is usually defined in terms of body mass index (BMI). Your BMI, a measure of weight to height, should stay between 18.5 and 24.9. A BMI of 25 or greater, especially if you have excess weight around your midsection, increases your risk of CAD. According to guidelines from the AHA, women and men should have a waist circumference of no more than 35 and 40 inches, respectively.
Your BMI isn’t always a perfect indicator, but it can be useful. You can use an online BMI tool or talk to your doctor about how your weight and overall health may affect your risk of developing CAD.
Diabetes is a condition in which your body can’t use insulin properly or can’t make enough insulin. This can lead to there being too much glucose in your blood. Other risk factors for CAD often accompany type 2 diabetes, primarily obesity. Your fasting blood glucose should be less than 100 mg/dL. Your hemoglobin A1c (HbA1c), an average measure of blood glucose control over three months, should be less than 7 percent. If either your blood sugar or your HbA1c is any higher than those values, you have a greater risk of developing CAD. If you have diabetes, talk to your doctor and follow their instructions for keeping your blood sugar under control.
Contributing risk factors
Certain behaviors can also increase your risk for heart disease, even if they aren’t classified as traditional risk factors. For example, frequent use of legal and illicit drugs can lead to high blood pressure and increased risk for heart failure or stroke. Use of cocaine and amphetamines increases your risk of developing heart disease.
Consuming large amounts of alcohol also increases risk. If you drink heavily or use drugs, consider talking to your doctor or a mental health provider about treatment or detox programs to avoid potentially dangerous health complications.
The first step is to know your risk factors. Even though you have no control over some of them, such as age and genetic factors, it’s still good to know about them. You can then discuss them with your doctor and monitor their effects.
You can change other factors. Here are some tips:
- Ask your doctor to monitor your blood pressure and cholesterol levels. If they’re outside recommended levels, ask your doctor for suggestions about how you can help reduce them.
- If you smoke, make a plan to quit.
- If you’re overweight, discuss a weight loss program with your doctor.
- If you have diabetes, ask your doctor for help with creating a plan to keep your blood sugar levels under control.
Managing your CAD risk factors can help you live a healthy, active life.