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 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 on to learn more.

What are the risk factors for CAD?

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. This is because plaque builds up over time. According to the National Heart, Lung, and Blood Institute, 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, according to a 2016 overview. The difference is less among people who aren’t white.

The death rate among women increases after menopause. A woman’s risk of death from CAD is equal to or greater than the same risk for a man by age 75.

Some degree of cardiovascular disease at the level of the heart muscle and coronary arteries often occurs as people age. The condition is identifiable in more than 80 percent of adults over age 80, according to a 2007 review.

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 with abnormal blood flow that attract plaque deposits and cause stiffening of the arteries.

Ethnicity

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
  • Asian-Americans
  • Pacific Islanders

The risk of heart disease is higher 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.

Non-Hispanic 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 mellitus. These are risk factors for heart disease.

Family history

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 further increased if your father or a brother received a diagnosis of heart disease before age 55, or if your mother or a sister received a diagnosis before age 65.

Additionally, if both of your parents had problems with heart disease before they were 55 years old, this will also significantly increase your risk for heart disease. You may also inherit a preponderance toward developing type 1 or 2 diabetes mellitus, 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:

Smoking

Even if you have no other risk factors, smoking tobacco products first or secondhand, 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 certain birth control pills.

Abnormal cholesterol levels

High low-density lipoprotein (LDL) cholesterol and low high-density lipoprotein (HDL) cholesterol are factors that can indicate a serious risk for CAD. LDL is sometimes referred to as “bad” cholesterol. HDL is sometimes referred to as “good” cholesterol.

High levels of LDL and low levels of HDL increase your risk of plaque building up in your arteries. There’s additional risk when either one of these is accompanied by a high triglyceride level.

There are new cholesterol guidelines for adults regarding what are considered acceptable and normal cholesterol levels from the American College of Cardiology and American Heart Association. The new guidelines also include the subsequent treatment approach when cholesterol levels are abnormal. Treatment takes into account if you have heart disease or risk factors for heart disease.

Your doctor will be able to check your different cholesterol levels in your bloodstream to see if they’re too high or low. If you have any type of cholesterol level abnormality, your doctor will be able to help you develop an effective treatment plan.

High blood pressure

Blood pressure is a measurement of pressure on the blood vessels when blood is flowing through them in relation to the heart’s motion of pumping or resting. Over time, high blood pressure, or hypertension, can cause the heart muscle to enlarge and not move correctly.

Aim to keep your blood pressure consistently below 120/80 mmHg. Systolic blood pressure is the top number. Diastolic blood pressure is the bottom number.

Stage 1 hypertension is defined as systolic blood pressure over 130 mmHg, diastolic blood pressure over 80 mmHg, or both. If you have high blood pressure, the AHA recommends that you start with some lifestyle changes that can help lower it:

  • Losing weight if you’re overweight and maintain a healthy weight.
  • Exercise regularly.
  • Limit the amount of alcohol you consume.
  • Eat a healthy diet.
  • Don’t smoke tobacco.
  • Manage stress healthily.

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.

Physical inactivity

Exercise helps lower your risk of CAD by:

  • lowering blood pressure
  • raising HDL cholesterol
  • strengthening your heart so it works more efficiently

Exercise also helps you maintain a healthy weight and reduces your risk for other diseases, such as obesity and diabetes mellitus, 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 mellitus. 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 should have a waist circumference under 35 inches. Men should have a waist circumference under 40 inches.

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 mellitus

Diabetes mellitus is a condition in which your body can’t use insulin properly or can’t make enough insulin. This leads to there being too much glucose in your bloodstream. Other risk factors for CAD often accompany type 2 diabetes, including obesity and high cholesterol.

Your fasting blood glucose should be less than 100 mg/dL. Your hemoglobin A1c (HbA1c) should be less than 5.7 percent. The HbA1C is a measure of your average blood glucose control over the prior two to three months. If either your blood sugar or your HbA1c is any higher than those values, you have a greater risk of developing diabetes mellitus or may already have diabetes mellitus. This increases your risk for having 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 certain legal and illicit drugs can lead to high blood pressure and increased risk for heart failure, heart attack, or stroke. Use of cocaine and amphetamines increases your risk of developing heart disease.

Heavy alcohol use also increases heart disease 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.

How to reduce your risk of CAD

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 tobacco products, make a plan to quit.
  • If you’re overweight, discuss a weight loss program with your doctor.
  • If you have diabetes mellitus, ask your doctor for help with creating a plan to keep your blood glucose level under control.

Managing your CAD risk factors can help you live a healthy, active life.