What is coronary artery disease?
Coronary artery disease is the narrowing of the blood vessels that supply nutrients to the heart. It is caused by the accumulation of fatty material on the inner lining of the arteries.
Individuals with CAD are understandably at high risk of heart attack or death. Certain other medical conditions are so frequently associated with the presence of heart attack or death from coronary artery disease that these conditions are called "coronary artery disease equivalents."
These conditions are:
- diabetes
- previous TIA ("mini-stroke") or stroke
- peripheral arterial disease including abdominal aortic aneurysm
Individuals with any one of these coronary artery disease equivalents may have a similar risk of developing heart attack or death as patients with documented CAD. Individuals with more than one of these conditions have a considerably higher risk.
How can I reduce the risk of CAD?
If you are at risk, lifestyle modification - such as adherence to a healthy diet, regular exercise, avoidance of tobacco products and maintenance of a healthy weight - is the foundation of risk reduction for CAD. Smoking cessation reduces the risk of coronary artery disease, and the decline in risk begins within months of quitting. Similarly, reduction in blood pressure and an increase in HDL cholesterol levels - ideally, through regular exercise - reduces the risk of coronary artery disease.
Risk Factors of CAD
In addition to coronary artery disease equivalents, there are other medical conditions that increase one's risk of developing symptomatic CAD.
These risk factors include:
- elevated LDL cholesterol level
- cigarette smoking
- history of high blood pressure (BP greater than 140/90)
- low HDL cholesterol (HDL less than 40 mg/dl)
- family history of coronary artery disease
- age (men older than 45 years, women older than 55 years)
Individuals with two or more of these risk factors may have the same or greater risk of death or heart attack as those with CAD or coronary artery disease equivalents. Identifying individuals with these risk factors and modifying their risk, where possible, improves outcomes.