As you can see, heart disease comes in a variety of life-threatening forms. All heart diseases are referred to as cardiovascular diseases (CVDs). CVDs include high blood pressure, coronary heart disease, congestive heart failure, stroke, rheumatic heart disease, artery diseases, pulmonary heart disease, and congenital cardiovascular defects.



Coronary heart disease, also referred to as coronary artery disease (CAD), is the most common form and represents 54 percent of all cardiovascular diseases. Coronary artery disease includes angina pectoris, which is chest pain from narrowing of blood vessels, and myocardial infarction (MI), also known as a heart attack, from the complete block­age of blood supply to the heart.

It is possible for a person to have more than one type of cardiovascular disease at the same time. For example, a person may have both coronary artery disease and high blood pressure. Coronary artery disease is responsible for more than half of all cardiac events in men and women under age seventy-five. According to the National Heart, Lung, and Blood Institute's Framingham Heart Study, the lifetime risk of developing CAD after age forty is 49 percent for men and 32 percent for women.

Scientists now know that atherosclerosis can start in childhood. Researchers have found the beginning of fatty streaks in the arteries of children as young as three years old. The average American has significant buildup in his or her arterial walls by middle age. In women, possibly because of the protective effects of estrogen, the thicker buildups do not begin to show up until after menopause.

Even without the impact of a stroke or heart attack, atherosclerosis advances the aging process. Healthy circulation in the body is the source of nutrition and life for the cells. As this circulation is slowly cut off, it impairs the functioning of your cells. Atherosclerosis does not need to be inevitable. With knowledge of the mechanisms that contribute to this disease, you can take steps to reduce your risks and to prolong your youthful vitality and energy.

Atherosclerosis and Coronary Artery Disease

The principle cause of coronary artery disease is atherosclerosis, or hardening of the arteries. Atherosclerosis comes from the root words "atheroma" and "sclerosis," which means "to harden." Atherosclerosis is a process that leads to a group of diseases characterized by the thickening of artery walls. The thickening results from a buildup of plaque on the arterial walls. Plaque is made up of various types of debris that collect on areas of inflammation on blood vessel walls, causing more and more narrowing of the passage through which blood can flow.

Plaque is formed in a variety of shapes and sizes. Small plaques accumulate throughout the arteries in the entire body and can be difficult to detect. Doctors can more easily discover the large, hardened plaques in the coronary arteries. These typically cause the chest pains associated with angina.

Small plaque buildups, however, are just as concerning as thick, hard plaques. Researchers now have determined that these smaller plaques are less solid on the outside and, consequently, less stable. These small, unstable plaques are much more likely to rupture and release the cholesterol mass into the bloodstream. This concentrated cholesterol contributes to formation of blood clots. If a small plaque buildup in the coronary arteries ruptures and forms a blood clot, it can trigger a heart attack.

As an initial assessment of your likelihood of having CAD, ask yourself the following questions:

Have you ever had a heart attack?

Have you had recurring chest pain that has been diagnosed as angina?

Have you had heart surgery such as a bypass operation or angioplasty procedure?

Have you ever had an angiogram that showed a blockage in your coronary arteries?

If you answered yes to any of these questions, you probably have CAD. Be sure to discuss strategies to manage your cholesterol levels with your health-care provider.