Coronary Heart Disease: Symptoms, Risk Factors +7 Tips to Improve Heart Health
Coronary heart disease, also known as coronary artery disease or CAD, occurs when plaque accumulates in the coronary artery walls, which provide blood to the heart (known as coronary arteries). Plaque buildup hinders the supply of oxygen-rich blood and nutrients to the heart muscle, potentially leading to a heart attack if the blockage becomes complete.
CAD is the most common type of heart disease in the United States, affecting around 18.2 million American adults (1). It is also the leading cause of death, claiming the lives of 375,476 Americans in 2021 (2).
Although heart disease can be fatal, it is preventable for most individuals. By implementing healthy lifestyle practices early on, you may be able to prolong your life while maintaining a healthier heart.
This article explores the causes of coronary artery disease and provides 7 easy ways to improve heart health.
Causes of Coronary Heart Disease
Coronary artery disease is caused by atherosclerosis, a gradual buildup of plaque in arteries throughout the body.
Plaque is made up of cholesterol, waste products, calcium, and fibrin, a substance that aids in blood clotting. The accumulation of plaque along artery walls causes them to become narrow and rigid, potentially leading to clogging or damage that restricts or halts blood flow to certain parts of the body.
When plaque builds up in the coronary arteries, the heart muscle is deprived of sufficient blood, oxygen, and nutrients, resulting in myocardial ischemia. This condition can cause chest discomfort (angina) and increase the risk of a heart attack.
If the artery is completely blocked, a heart attack will occur. This is because blood can't get to the heart muscle, and the tissue begins to die from a lack of oxygen. In certain situations, this can result in heart failure.
Risk Factors for Coronary Artery Disease
Heart disease has numerous risk factors, some of which can be controlled while others cannot. The CDC reports that approximately 47% (3) of people in the U.S. have a minimum of one risk factor for heart disease. Examples of controllable risk factors include the following:
Obesity
Obesity is characterized by excess body fat, also known as adipose tissue, which can negatively affect one's health. Being obese, defined as having a body mass index (BMI) of 30 or more, increases your risk of developing numerous health conditions, including type 2 diabetes, sleep apnea, high blood pressure, cancer – and heart disease.
According to a comprehensive study conducted in 2018, individuals who are obese are not only more susceptible to heart disease, but they also have a higher risk of mortality from heart disease. This is in comparison to those who maintain a healthy BMI (4)..
Inflammation
Researchers discovered twenty years ago that high levels of inflammation increase the risk of heart attacks and strokes. But at that time, they were unsure if taking anti-inflammatory treatments could prevent such events from happening.
That all changed with the Cantos clinical trial, published in 2017. The researchers injected an anti-inflammatory drug into patients who had survived a heart attack and were taking statins but continued to display inflammatory markers.
The results? According to Johns Hopkins:
“People treated with the novel anti-inflammatory treatment reduced their likelihood of subsequent heart attacks or strokes by 15 percent. It also decreased the need for major interventions such as angioplasty and bypass surgery by 30 percent, proving that addressing inflammation to prevent heart disease is essential.” (11)
How can inflammation cause coronary heart disease?
Whenever your body is injured or ill, inflammation plays a crucial role in your immune response. It helps combat germs and promote healing. However, the buildup of cholesterol and other substances in your arteries can also trigger an inflammatory response.
While this can be useful for short-term conditions, prolonged low-level inflammation can be harmful. It can irritate your blood vessels, promote plaque growth, loosen plaque in your arteries, and lead to blood clots. These blood clots are the primary cause of heart attacks and strokes.
When a blood clot obstructs an artery to the heart, it results in a heart attack. On the other hand, if it blocks an artery to the brain, a stroke occurs (11).
Family History
If any of your close family members (parent or sibling) have a history of heart disease, you are more susceptible to developing coronary artery disease. The likelihood of this increases if the said family member was diagnosed with heart disease at an early age.
The risk is highest if your father or brother were diagnosed with heart disease before turning 55 or if your mother or sister developed it before turning 65.
Smoking
According to the National Institute of Diabetes and Digestive and Kidney Diseases, individuals who smoke are at a doubled risk of developing heart disease (5).
You are also at increased risk of heart disease if you breathe in second-hand smoke.
High blood pressure (hypertension)
Blood pressure is a measurement of the force of blood against the walls of arteries as it flows through the body. High blood pressure, also known as hypertension, occurs when this force is consistently too high, which can cause arteries to become rigid and inflexible, leading to arterial damage, reduced blood flow through the coronary arteries, and health complications like coronary heart disease.
Among the cardiovascular disease risk factors, high blood pressure (BP) has the most substantial evidence of causation and is widely prevalent. Indeed, many researchers consider hypertension the primary risk factor for coronary heart disease (6).
High cholesterol
Did you know that cholesterol, a type of fat, plays a vital role in performing various essential bodily functions? However, an excessive amount of cholesterol in your bloodstream can cause harm. It can penetrate your artery wall, impair its integrity, and cause the formation of hardened deposits known as atherosclerotic plaque.
This condition is called atherosclerosis and can lead to severe health issues, including coronary artery disease and stroke. High cholesterol is only one of the risk factors for heart disease, but it’s an important one.
Chronic stress
Experiencing psychological stress has the potential to harm the arteries and exacerbate other risk factors associated with coronary artery disease.
Alcohol consumption
Excessive consumption of alcohol can cause damage to the heart muscles and aggravate other risk factors associated with coronary artery disease.
Lack of physical activity
According to Johns Hopkins Medicine, “Studies show that physically active people are less likely to develop coronary heart disease than those who are inactive. This is even after researchers accounted for smoking, alcohol use, and diet.”
Obstructive sleep apnea
The most frequently occurring sleep-related breathing disorder is obstructive sleep apnea, which leads to recurrent interruptions in breathing during sleep.
Obstructive sleep apnea is the most common type of sleep apnea, which happens when the muscles in your throat relax intermittently and obstruct your airway while you sleep. Snoring is a common symptom of obstructive sleep apnea.
How does obstructive sleep apnea increase your risk for coronary artery disease? The interruptions in sleep may result in sudden drops in blood oxygen levels, causing the heart to work harder and leading to increased blood pressure.
Diabetes
The American Heart Association reports that “Diabetes [is] one of the seven major controllable risk factors for cardiovascular disease (CVD).” (7)
It's a known fact that individuals with Type 2 diabetes have a higher risk of developing and succumbing to cardiovascular diseases, such as heart attacks, strokes, and heart failure. In addition, they are twice as likely to experience these conditions compared to those without diabetes (7).
Type 2 diabetes and coronary artery disease have common risk factors such as obesity and high blood pressure.
Depression
Individuals who suffer from a depressive disorder or experience symptoms of depression are at a higher risk of developing coronary artery disease, with a 64 percent increased likelihood, according to research (8)
This risk increases even further for people who have had depression for more than 10 years. Therefore, it is essential for those suffering from depression to seek treatment to reduce the risk of coronary artery disease.
Poor-quality diet
Consuming meals that are high in saturated and trans fats, salt, and sugar can elevate the likelihood of developing coronary artery disease.
It's common for risk factors to coincide and potentially trigger each other. When certain risk factors are combined, the likelihood of developing coronary artery disease increases.
An illustration of this is metabolic syndrome, which is a combination of conditions like high blood pressure, high blood sugar, excess body fat around the waist, and high triglyceride levels. This cluster of conditions heightens the risk of developing coronary artery disease.
Therefore, it's essential to be aware of the risk factors for coronary artery disease and to take steps to reduce and manage them. This includes getting regular medical checkups, eating a healthy diet, and exercising regularly – more about that below.
Symptoms of Coronary Heart Disease
Coronary heart disease can be "silent," with no noticeable symptoms until a heart attack or other complication arises. This makes it difficult to diagnose the disease before it becomes a problem. In other words, the first sign of coronary heart disease is often when you experience a heart attack.
Therefore, prevention is crucial in the fight against heart disease.
Heart Attack Symptoms
Symptoms of a heart attack include:
- Angina (chest pain). This pain may present as a squeezing sensation. It may also feel like pressure, tightness, or a burning sensation that can be mistaken for heartburn. The pain or discomfort often begins behind the breastbone but may manifest in the throat, jaw, arms, shoulders, or back.
- Dizziness
- Light-headedness
- Cold sweats
- Nausea
- Indigestion
- Shortness of breath, which will be especially likely with physical activity
- Pain in the neck
- Weakness
Remember that angina is not always the sign of a heart attack, but it is a symptom of coronary artery disease.
It is less common for women to experience chest pain during a heart attack than for men. Instead, they may be more likely to experience other symptoms, including:
- Nausea
- Dizziness
- Tightness or pressure in the chest
- Significant fatigue
- Stomach pain
It's possible to experience symptoms of a sudden heart problem, like chest pain, shortness of breath, or neck pain, that disappear when you rest and return when you're active.
These symptoms can worsen as plaque buildup continues to narrow the coronary arteries. In addition, it could be a sign of a heart attack if you're experiencing chest pain or discomfort that persists or occurs more frequently, even while resting.
If you're unsure whether your chest pain is angina or a heart attack, it's important to call 9-1-1 immediately. A healthcare professional should evaluate all chest pain. Time is of the essence when it comes to heart attacks; the sooner you receive medical attention for a heart attack, the better your chances of survival and a full recovery.
Don't wait to call for help if you think you may be having a heart attack.
Medical Treatments
Fifty years ago, coronary heart disease claimed the lives of a far higher percentage of patients, but today's doctors have better techniques for managing the symptoms. While specific treatments work to lower blood pressure, triglycerides, and cholesterol, others only address symptoms instead of the underlying issue.
Most doctors recommend a treatment plan that combines prescription medication and lifestyle changes for those with coronary heart disease. The type and severity of the disease, as well as your symptoms, will determine the number of medicines you are prescribed to manage high blood pressure and high cholesterol, and prevent diabetes or other complications.
Common medications used to treat CHD include aspirin, beta-blockers, nitroglycerin, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs).
Many people can naturally prevent CHD or recover from it by adopting a healthy lifestyle. This involves making dietary changes, achieving and maintaining a healthy weight, quitting smoking, achieving restful sleep, becoming more physically active, and more, which we’ll discuss below.
7 Natural Strategies to Improve Heart Health
Heart disease is a significant cause of death, but it is not always inevitable. Though there are certain risk factors that cannot be altered, such as family history, sex, or age, there are many methods to lower your chances of developing heart disease.
The heart-healthy power of lifestyle changes cannot be understated.
For example, according to a study conducted in 2016, adopting a healthy lifestyle that includes regular exercise, a balanced diet rich in fruits, vegetables, and grains, and abstaining from smoking can decrease the risk of heart disease, even if there is a genetic predisposition for developing it. The study analyzed a total of 55,685 participants.
And guess what?
According to the investigators, genetics can increase the risk of heart disease by two-fold, but a healthy lifestyle can reduce it by half. Equally significant, they discovered that an unhealthy lifestyle could nullify about fifty percent of the advantages of good genes (11)
These impressive results indicate that lifestyle choices are still the most critical factor in reducing the risk of heart disease, regardless of genetics.
Below are 7 lifestyle changes you can begin making today to reduce your heart disease risk in the future.
1. Eat a heart-healthy diet.
Maintaining a healthy heart and practicing good nutrition are interconnected. Adopting a diet that is based on whole foods can effectively lower the risks of inflammation, high blood pressure, and unhealthy high cholesterol. For example, incorporating potassium-rich fruits and vegetables into your diet can help lower blood pressure. Additionally, consuming healthy food will aid in weight management and provide more energy for physical activities, which are crucial in averting coronary heart disease.
More significantly, making the right dietary choices can address risk factors associated with heart disease and heart-related conditions. Therefore, consuming healthier foods can prevent specific health issues from developing in the future.
To keep your heart healthy, experts have issued the following recommendations (9):
Eat more
- Nonstarchy vegetables
- Lean animal protein
- Fish (for ultimate heart health, try to eat fish three times per week)
- Low-sugar fruits, such as berries, citrus fruits, and cherries
- Nuts
- Whole grains
- Fiber
Most of the above foods are anti-inflammatory in nature.
Eat less
- Red meats (beef, pork, lamb, veal)
- Processed meats (hot dogs, luncheon meat, pepperoni, salami)
- Saturated fats
- Trans fats
- Refine carbohydrates and heavily process foods (baked goods, crackers, white bread, potato chips)
- Soda and other sweetened beverages
The foods on the “eat less” list promote inflammation.
Maintaining moderation is essential when it comes to your diet. While completely eliminating certain items may be challenging, it's okay to occasionally enjoy a small serving of an unhealthy treat without feeling guilty. The key is to ensure the portion size is small.
Eating in moderation can also help prevent binging on unhealthy foods. It’s important to remember to balance out your diet with nutrient-dense foods, such as fruits and vegetables, to ensure you are getting all the nutrients your body needs.
2. Maintain a healthy weight.
Heart disease is often linked to obesity since excessive weight can cause the accumulation of fatty substances in the arteries, raising the risk of heart attacks and other related conditions.
It's recommended to adopt a balanced diet and exercise regularly to achieve a healthy weight. However, practicing portion control and planning well-balanced meals to maintain optimal health are equally crucial.
Losing weight, even just a little bit, can bring significant benefits. A mere 3% to 5% reduction in weight can lead to a decrease in triglycerides, a lowering of blood sugar levels, and a reduced risk of developing type 2 diabetes. Shedding even more weight can further help lower blood pressure and cholesterol levels (12).
3. Exercise regularly
Engaging in regular physical activity on a daily basis can significantly reduce the risk of heart disease. In addition, physical activity is useful in controlling weight and preventing the development of other conditions that may put a strain on the heart, including high blood pressure, high cholesterol, and type 2 diabetes.
If you have been inactive for a while, gradually work your way up to the recommended goals. Ideally, you should aim to achieve at least 150 minutes of moderate aerobic exercise, such as brisk walking, or 75 minutes of vigorous aerobic activity, like running, and two or more strength training sessions per week.
Even brief bouts of activity can confer heart benefits, so if you are unable to meet these guidelines, do not despair. Activities such as gardening, housekeeping, taking the stairs, and walking your dog can all contribute towards your total.
You need not exercise vigorously to reap the benefits, but you can maximize the advantages by increasing your workouts' intensity, duration, and frequency.
4. Get an adequate amount of quality sleep.
Getting sufficient sleep is crucial to maintaining good health and reducing the risk of various health issues such as obesity, high blood pressure, heart attack, diabetes, and depression.
As an adult, it is recommended that you get at least seven hours of sleep every night. You can prioritize sleep in your life by establishing a regular sleep schedule and sticking to it. Ensure that your bedroom is quiet and dark to facilitate better sleep.
If you still feel tired during the day despite getting enough sleep, consult your healthcare provider to determine if you may have obstructive sleep apnea. Symptoms of this condition include loud snoring, brief breathing pauses during sleep, and gasping for air upon waking up.
Treatment options for obstructive sleep apnea may involve weight loss if overweight or using a continuous positive airway pressure (CPAP) device to keep the airway open while sleeping.
5. Manage stress.
As human beings, we experience over a thousand diverse biochemical reactions to cortisol, a stress hormone. These reactions include heightened blood pressure and heart rate, which can adversely impact our heart health. Therefore, adopting effective stress management techniques is crucial to protecting our hearts.
One way to manage stress is through mindfulness and meditation. Practicing mindfulness can help regulate emotions, improve focus, and prevent overthinking. Regular physical activity can also help release endorphins, reducing stress levels and improving overall well-being.
Other stress-relieving activities include yoga, bicycling, slow breathing exercises, massage, and swimming…really, any pleasurable activity decreases stress.
6. Quit smoking.
Taking care of your heart should be a top priority, and a great way to start is by quitting smoking or using smokeless tobacco. Even if you're not a smoker, avoiding secondhand smoke is crucial.
Tobacco is known to contain harmful chemicals that can damage both the heart and blood vessels. Cigarette smoke can also decrease the amount of oxygen in the blood, increasing blood pressure and heart rate. This puts more strain on the heart to supply enough oxygen to the body and brain.
The good news is that even just a day after quitting, the risk of heart disease starts to decrease. After a year without cigarettes, the risk drops to about half that of a smoker. Regardless of how long or how much you smoked, you will begin to see benefits as soon as you quit. Your throat even cleans up too!
Quitting smoking is a long-term process, but the sooner you begin, the sooner you will reap the health benefits. Reducing your risk of heart disease, stroke, and cancer are just some of the many advantages of quitting.
If you need help quitting smoking, call 1-800-QUIT-NOW for free help.
7. Get regular health checkups.
Regular health screenings with your general practitioner or a specialist regarding a specific health concern are essential for maintaining good heart health. During these consultations, your doctor will measure your blood pressure, observe your heart, and assess other aspects of your well-being to detect any potential issues.
It's essential to be aware that high blood pressure, high cholesterol, high blood glucose, etc., can have damaging effects on the heart and blood vessels. However, it's easier to determine whether you have these conditions with proper screening. By undergoing regular screening, you can obtain accurate measurements of your numbers and determine if any necessary action needs to be taken.
It's important to talk to your doctor about what screening is necessary and what the ideal measurements should be. Taking proactive steps to monitor and manage your health can help you reduce your risk of serious conditions and complications.
References
1- https://www.nhlbi.nih.gov/health/coronary-heart-disease
2- https://www.cdc.gov/heartdisease/facts.htm
3- https://www.cdc.gov/heartdisease/facts.htm
4- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5875319/
5- https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke
6- https://pubmed.ncbi.nlm.nih.gov/31865786/
7-
https://www.hopkinsmedicine.org/health/conditions-and-diseases/risks-of-physical-inactivity
8- https://www.nhlbi.nih.gov/news/2017/heart-disease-and-depression-two-way-relationship
9- https://health.clevelandclinic.org/heart-healthy-diet/
10- https://www.nytimes.com/2016/11/14/health/genetic-heart-disease-risk-eased-by-healthy-habits-study-finds.html
11-
https://www.hopkinsmedicine.org/health/wellness-and-prevention/fight-inflammation-to-help-prevent-heart-disease