Coronary Heart Disease: The Essential Guide
How do you keep your heart happy?
The heart is one of the most energy-hungry organs in your body. No surprises there – it works 24/7 to keep your blood moving and deliver oxygen and nutrients to other organs. But, the heart itself also needs an oxygen and energy supply, which is precisely what the coronary arteries do.
The heart’s blood vessels are only around ⅛ inch wide or about the width of a drinking straw.  As we age, plaques of fat and inflammatory cells build up in our arteries, and the coronaries are no exception. These plaques block blood flow, impairing normal heart function.
Coronary heart disease is a catch-all term for when the coronary arteries don’t supply enough oxygen-rich blood to the heart.  You might not experience symptoms for a while, but CHD could also present as chest pain, a heart attack, or sudden cardiac arrest. In fact, coronary heart disease is the leading cause of death in the US. 
The good news?
Deaths from CHD are actually declining in recent years  thanks to our improved understanding of the disease. And, while treating coronary heart disease can involve invasive therapies, there is also plenty you can do to lower your own risk – no medications or metal wires in your blood vessels involved.
In this article, we’ll give you a comprehensive overview of coronary heart disease – what causes it, who is at risk, and what are the symptoms to look out for. More importantly, we will show you how to protect your heart as you age, whether you’ve had previous heart trouble or not. Read on to begin treating your heart right:
Coronary heart disease happens when atherosclerotic plaques form inside your blood vessels. A plaque is a buildup of fat in the internal lining of the arteries (known as the intima). This leads to a stiffening vessel wall or sclerosis (from Greek, “hard”), reducing blood flow and cutting the heart’s access to oxygen and nutrients.
What is more, plaques can break, exposing the lipids inside to the blood flow. A blood clot forms around the exposed fat, potentially blocking the entire vessel.  This is one of the common mechanisms for a heart attack – and if parts of the blood clot break, they could also travel to other parts of the body (e.g., to the brain causing a stroke.)
Ultimately, the cause for coronary heart disease is simple – the fatty plaques in the coronary arteries. But what makes the plaques form? Let’s talk about risk factors:
Coronary heart disease affects millions of Americans every year, which is why its risk factors have been well-studied and understood. 
Scientists divide CHD risk factors into two main groups:
Factors You Can’t Control
As you age, atherosclerotic plaques grow.
For men, the risk of CHD increases after 45 years, while women are at lower risk until menopause.  The majority of coronary heart disease deaths happen after age 65. 
Family history is another significant risk factor.
If you have a first-degree relative with heart disease, your chances of developing it increase. This is especially true if you have a male relative diagnosed before 55 or a female relative diagnosed before 65.
Certain racial groups have a higher risk of coronary heart disease.
African-Americans are 30% more likely to die from heart disease. They are also more likely to have high blood pressure and control it poorly.  Other at-risk racial and ethnic groups include Mexican-Americans, American Indians, native Hawaiians, and some Asian Americans.
Men have higher rates of heart disease.
The male gender is an independent risk factor for CHD. Even after menopause, women are less likely to develop or die from plaque obstruction.
If you fall in an at-risk group, the prospect of heart disease and its complications is understandably scary. However, by controlling your modifiable factors, you can significantly lower your risk. Here is how to do that:
Factors You Can (And Should) Control
Over time, your lifestyle affects every aspect of health, including heart health. Here are the main controllable risk factors – and the simple steps to take for prevention:
When you smoke, over 4000 different toxins flood your system. Chemicals in tobacco smoke damage the interior lining of blood vessels, increase clot formation, and reduce nitric oxide (which widens arteries and prevents infarction.) 
This applies to both active and passive smoking (or exposure to tobacco smoke). And, while the tobacco damage is significant, the benefits of stopping are also far-reaching.
Smoking cessation reduces your chances of developing and dying from heart disease very quickly. It even works if you stop after 65 or after a heart event like a myocardial infarction. .
Having trouble kicking the habit? There are multiple strategies that could help, including nicotine replacement therapy or alternative treatments like acupuncture, black pepper oil, or hypnotherapy. , , .
Physical Inactivity & Obesity
A sedentary lifestyle increases your risk of heart disease and boosts other risk factors like obesity, diabetes, and abnormal cholesterol. Adopting an exercise regimen is one of the most efficient ways to prevent CHD – and it has minimal side effects.
The WHO recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity throughout the week to adults over 65.  Some of the best workouts to adopt as you age include water aerobics, yoga, and pilates, as well as any bodyweight exercise. Even a long walk makes a significant difference in your heart health – plus, it lowers your risk for a number of other conditions.
Being overweight also speeds up atherosclerosis and leads to a higher risk of CHD. Maintain a healthy weight through a nutrient-dense diet and exercise to enjoy a healthy, happy heart.
Not all cholesterol is bad cholesterol. It’s the combination of high LDL cholesterol and low HDL that raises your risk of coronary heart disease. Elevated LDL, in particular, is a major risk factor .
Your primary care doctor will evaluate your cholesterol levels and might recommend medications to reduce them. Statins are the first-line therapy – and now they’re prescribed based on your heart disease risk, not just on your cholesterol. 
In the US, statins are one of the most prescribed medications, but some people are reluctant to take them. Statin opponents cite the minimal benefit to most people (one in ten people taking a stain will experience the perks) and the side effects as reasons to ditch the drug. And, while these are understandable concerns, some people can gain up to six years of life from taking a statin and the unpleasant effects are often due to a nocebo effect (knowing a tablet might hurt you). , 
Does this mean statins are the one-size-fits-all solution to Coronary Heart Disease? Definitely not. Switching to a plant-centered diet, taking supplements like fish oil or red yeast rice, and increasing physical activity will all lower your LDL cholesterol. But, if you’ve been offered a stain, make sure you read both parts of the statin argument before declining the medication.
Poor Sleep Quality
One of the little-known risk factors for heart disease is not getting enough quality sleep. Getting less than 6 hours of sleep and sleep disturbance both increase your chances of developing CHD and dying from a heart event. 
Even though individual sleep needs vary and change as you age, maintaining a healthy sleep schedule is one of the most heart-healthy things you can do. To improve your sleep quality, reduce electronics before bed, aim to fall asleep and wake up around the same time, and consider calming supplements like melatonin, valerian root, ashwagandha, and Rhodiola.
Signs, Symptoms, and Complications
CHD is a disease of your blood vessels. How it presents in your system, however, will vary widely. Some people are asymptomatic for years, even though their hearts struggle to get enough oxygen and nutrients. Others can experience sudden cardiac arrest from a ruptured plaque – and this might be the first time the disease shows up.
Because coronary heart disease has such a wide range of presentations, it’s important to know the warning signs of trouble:
- Chest pain, pressure, or discomfort
- Heart palpitations
- Shortness of breath
- Tiredness (meaning you can’t do your usual activities)
- Leg swelling (which is a warning sign of heart failure)
Some of the CHD complications are life-threatening – heart attacks, heart failure, and cardiac arrest being some of them. These usually happen when there is a complete blockage of the artery – or a significant obstruction over a long time.
If you notice any heart-related symptoms whatsoever (things like chest pain and shortness of breath), talk to a medical professional immediately.
If your doctor suspects you have coronary heart disease, they will likely run blood tests like a complete blood count (CBC), chemistry panel, and lipid profile. You might also get your blood sugar levels measured since diabetes is also a risk factor for heart disease. Your physician will also do an ECG to monitor the electrical activity of your heart and evaluate any changes. Most doctors use a heart risk calculator to place you in a risk group and decide how they’ll treat you. In some cases, imaging can help to confirm the diagnosis, and yet in others, coronary angiography is performed to find the obstruction and remove it.
The good news with coronary heart disease is we have advanced methods of treating and preventing it. Invasive techniques like revascularisation can be the difference between life and death in situations like myocardial infarction.
But, our goal with this blog is for you to never need an invasive procedure or even medication. Whether you’ve had a heart issue before or you’re looking to prevent your risk in the future, there are multiple effective and safe strategies to keep your heart healthy. Here are the most important (non-pharmaceutical, non-invasive) steps to take:
- Ditch the cigarettes. Tobacco is a risk factor for various diseases – from CHD to cancer and everything in between. To help with smoking cessation, consider nicotine replacements, hypnotherapy, acupuncture, and a black pepper oil supplement.
- Get your cholesterol under control by reducing animal fats and simple carbs (white bread, pasta) in your diet. Try an LDL-reducing supplement like red yeast rice, a staple in traditional Chinese medicine for centuries.
- Move your body. Regular physical activity helps you maintain a healthy weight and keeps your heart happy. Try a low-injury-risk exercise like water aerobics or yoga.
- Optimize your sleep. Make sure you get enough quality sleep by sticking to sleep schedule, cutting down electronics before bed, and introducing supplements like melatonin or valerian root.
- Introduce blood-thinning foods. Doctors will often prescribe blood thinners to reduce your chances of developing a deadly blood clot. Some foods and supplements can have a similar effect. Turmeric , garlic and garlic powder , and ginkgo  are some of the low-risk, high-benefit items to introduce to your diet.
As you age, coronary heart disease becomes a significant risk to your health. However, with the right lifestyle and prevention interventions, you can take charge of your own well-being and prevent heart trouble. A happy heart means a longer, healthier life – and maintaining heart health is often as simple as a healthy diet and exercise. So, empower yourself to take care of your body now and notice how it will thank you.