What Is Coronary Heart Disease?

MONDAY, Feb. 6, 2023 (HealthDay News) -- That seemingly sudden heart attack? It may have been triggered by underlying coronary heart disease.

Heart attack is a big event, but for some it might be the first sign of a problem that has been building for quite some time.

Coronary heart disease -- also known as coronary artery disease -- is the most common type of heart disease in the United States, according to the U.S. Centers for Disease Control and Prevention.

Doctors often use the terms coronary heart disease (CHD) and coronary artery disease (CAD) interchangeably, although CHD is really a result of CAD, according to the American Heart Association (AHA).

“Coronary artery disease is preventable,” Dr. Johnny Lee, president of New York Heart Associates, said in a recent story about the condition. “Typical warning signs are chest pain, shortness of breath, palpitations and even fatigue.”

What is coronary heart disease?

The condition happens when blood flow to the heart muscle is limited because of plaque growth caused by waxy cholesterol in the coronary artery walls, according to the AHA.

It affects the large arteries on the surface of the heart, according to the U.S. National Heart, Lung, and Blood Institute (NHLBI).

That plaque may narrow the arteries over time. Or a sudden rupture of plaque may lead to blood clot, according to the AHA. That narrowing process, called atherosclerosis, can block some or all blood flow.

It’s so common that 18.2 million Americans have CHD, the leading cause of death in this country, the NHLBI noted.

The latest AHA statistics show that the prevalence of cardiovascular disease was 48.6% in adults 20 and older. CVD numbers include those with coronary heart disease, heart failure, stroke and hypertension.

What causes coronary heart disease?

Although people may think of heart disease as an issue for seniors, it’s never too early to start protecting against it.

The disease can begin in childhood, noted Dr. Edward Fisher, a professor of cardiovascular medicine at NYU School of Medicine in New York City.

“Preventive measures instituted early are thought to have greater lifetime benefits. Healthy lifestyles will delay the progression of CAD, and there is hope that CAD can be regressed before it causes CHD,” Fisher said recently.

Certain lifestyle behaviors can put someone at higher risk for heart trouble. These include physical inactivity, unhealthy eating and smoking, the CDC said. Having high cholesterol levels is another risk factor, as is high blood pressure, diabetes and obesity, according to AHA.

Chronic kidney disease, high stress and poor sleep can also factor into heart disease, according to the Mayo Clinic.

So do obstructive sleep apnea, high-sensitivity C-reactive protein and preeclampsia during pregnancy, along with autoimmune disorders such as rheumatoid arthritis and lupus.

Women have higher risks after menopause, while men do after age 45.

Some of the risks are genetic, especially if there is a family history of heart problems before age 50, the CDC added.

Coronary heart disease symptoms

Chest pressure, pain or tightness can suggest CHD, according to Mayo Clinic. Shortness of breath and fatigue are signs, too.

Other symptoms include weakness, lightheadedness, nausea, a cold sweat or pain/discomfort in the arms or shoulder.

For some, the big symptom may be an actual heart attack.

Coronary heart disease treatments

A variety of tests can help diagnose the condition. Treatments include surgical procedures to restore blood flow, according to the CDC.

Surgical options include angioplasty and stent placement, coronary artery bypass surgery and minimally invasive heart surgery, according to Mount Sinai, in New York City.

Medicines can treat risk factors.

Lifestyle changes include a diet that’s lower in sodium and fat, exercising more, quitting smoking and getting to a healthy weight.

How to prevent coronary heart disease

It is possible to prevent this disease or further damage once it’s diagnosed.

Smokers should quit immediately, Mount Sinai advised.

Talk to a doctor about starting an exercise routine. Exercise at moderate to vigorous intensity about 30 minutes daily.

Manage other health conditions with medications and lifestyle changes.

A healthy diet could include replacing butter and other saturated fats with olive and canola oils, Mount Sinai noted.

Don’t sprinkle salt on food, because that raises the risk of heart disease, heart failure and plaques in your arteries, suggested a study published recently in the Journal of the American College of Cardiology.

"Compared with people who always added salt to foods -- usually at the table -- those who sometimes, rarely or never added salt to foods had up to 37% reduction in the risk for cardiovascular disease," said lead researcher Dr. Lu Qi, a professor in the department of epidemiology at Tulane University School of Public Health and Tropical Medicine in New Orleans.