Coronary Artery Disease (CAD) Risk Factors

Written by the Healthline Editorial Team | Published on July 29, 2014
Medically Reviewed by George Krucik, MD, MBA on July 29, 2014

Heart Disease Overview

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 385, 000 die from CAD each year in the United States. The most common cause of CAD is plaque buildup in the coronary arteries. There are many factors that increase your risk of developing CAD. Some of these factors you can control; others you cannot.

Risk Factors You Cannot Control

You can do a lot to lower your risk of developing coronary artery disease, but some risk factors are beyond your control. It's important to be aware of them.

Age and Gender

Plaque builds up over time, so CAD becomes more of a possibility as you get older. 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. According to the Merck Manual, in the 35 to 44 age group, white men are 6.1 times more likely to die of CAD than white women. There is less difference among nonwhites. The death rate among women increases after menopause. According to the Merck Manual for Health Care Professionals, by age 75, a woman’s risk of death from CAD is equal to or greater than the risk for a man..

One risk factor that only affects women is preeclampsia. This is condition occurs during pregnancy and is characterized by an increase in blood pressure to serious levels and protein in the urine. (NIH, 2011). An article published in BMJ Group’s Postgraduate Medical Journal indicates that some degree of CAD is almost inevitable, with the condition identifiable in more than 80 percent of adults over age 80.. Changes that occur in the body as we age create optimal conditions for heart disease to gain a foothold. For instance, as we age, the smooth artery vessel walls naturally develop  rough surfaces that attract plaque deposits.

Race/Ethnicity

In the United States, heart disease is the leading cause of death for most ethnicities. According to the CDC, for American Indians, Alaska natives, Asian Americans, and Pacific Islanders, heart disease is second only to cancer as a cause of death.

For some ethnicities, the risk of heart disease is higher than for other ethnicities. According to the U.S. Department of Health and Human Services Office of Minority Health (OMH), in 2009, African American men and women in the United States were 30 percent more likely to die of heart disease, including coronary artery disease, than white men. Whites have a significantly higher death rate from heart disease than American Indians and Alaska natives.

The increased risk of heart disease in some ethnicities is associated with increased rates of high blood pressure, obesity, and diabetes.

Other Genetic Factors

Heart disease may run in the family. Your heart disease risk is increased 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 CAD risk.

Risk Factors You Can Control

Fortunately, many risk factors for CAD are well within your control. According to the American Heart Association, there are six major risk factors you can change.

Smoking

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 Cholesterol

High LDL (bad) cholesterol and low HDL (good) cholesterol are factors that can indicate a serious risk for CAD. High LDL and low HDL increase your risk of building up plaque in your arteries. If you have trouble keeping straight which kind of cholesterol is good and which is bad, the National Heart, Lung, and Blood Institute suggests a nifty way to remember: When you hear the “L” in LDL, think “lousy” and “lower.” When you hear the “H” in HDL, think “healthy” and “higher.”

Your LDL reading should be less than 100 milligrams of cholesterol per deciliter of blood (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 (Hypertension)

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. Your blood pressure should remain consistently at or below 120/80 mmHg.

Physical Inactivity

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) that might lead to CAD.

Overweight or Obesity

The terms “overweight” and “obese” are more than unflattering adjectives; they’re medical diagnoses. Being overweight or obese increases CAD risk dramatically. Furthermore, carrying too much weight often goes hand in hand with high blood pressure or diabetes, and it’s directly related to poor diet and physical activity habits.

Overweight and obesity are 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 carry your weight around your midsection, increases CAD risk. Women and men should have a waist circumference of no more than 35 and 40 inches, respectively. Catching a glimpse of yourself stepping out of the shower is all you probably need to determine whether you're too chunky, but you should know your BMI. Use an online BMI tool or ask your healthcare provider to calculate the number for you.

Diabetes

Diabetes is a condition in which there is too much glucose in your blood because your body can’t use insulin properly or can’t make enough insulin. Type 2 diabetes is often accompanied by other risk factors for CAD, primarily obesity. Your fasting blood glucose should be less than 100 mg/dL, and your HbA1c, an average measure of blood glucose control over a period of three months, should be less than seven percent. Any higher on either count and you run a greater risk of CAD. If you have diabetes, talk to your doctor and follow his or her instructions for keeping your blood sugar under control.

Contributing Risk Factors

Certain behaviors can also increase your risk for heart disease, even if they are not 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.

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