We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including coronary heart disease. Learn about current and future NHLBI efforts to improve health through research and scientific discovery.
Learn about the following ways the NHLBI continues to translate current research into improved health for people with heart disease.
Learn about some of the pioneering research contributions we have made over the years that have improved clinical care. In support of our mission , we are committed to advancing coronary heart disease research in part through the following ways. We lead or sponsor many studies on coronary heart disease. See if you or someone you know is eligible to participate in our clinical trials and observational studies. To learn more about clinical trials at the NIH Clinical Center or to talk to someone about a study that might fit your needs, call the Office of Patient Recruitment Learn more about participating in a clinical trial.
View all trials from ClinicalTrials. After reading our Coronary Heart Disease Health Topic, you may be interested in additional information found in the following resources. Coronary Heart Disease. Coronary heart disease is a type of heart disease that develops when the arteries of the heart cannot deliver enough oxygen-rich blood to the heart.
It is the leading cause of death in the United States. Coronary heart disease is often caused by the buildup of plaque, a waxy substance, inside the lining of larger coronary arteries. This buildup can partially or totally block blood flow in the large arteries of the heart.
Some types of this condition may be caused by disease or injury affecting how the arteries work in the heart. Coronary microvascular disease is another type of coronary heart disease.
Symptoms of coronary heart disease may be different from person to person even if they have the same type of coronary heart disease. However, because many people have no symptoms, they do not know they have coronary heart disease until they have chest pain, a heart attack, or sudden cardiac arrest. If you have coronary heart disease, your doctor will recommend heart-healthy lifestyle changes, medicines, surgery, or a combination of these approaches to treat your condition and prevent complications.
Explore this Health Topic to learn more about coronary heart disease, our role in research and clinical trials to improve health, and where to find more information.
Causes - Coronary Heart Disease. Plaque buildup. Normal versus a blocked artery. The image shows a normal coronary artery with normal blood flow and a blocked coronary artery narrowed by plaque.
The buildup of plaque limits the flow of oxygen-rich blood through the artery. Problems affecting the blood vessels. The cause of these problems is not fully clear. But it may involve: Damage or injury to the walls of the arteries or tiny blood vessels from chronic inflammation , high blood pressure , or diabetes. Molecular changes that are part of the normal aging process.
Molecular changes affect the way genes and proteins are controlled inside cells. Spasm and plaque buildup can cause your arteries to narrow. Top left: image of a heart showing the coronary arteries.
Top right: This artery does not have plaque buildup but has a vasospasm, causing it to narrow. This is a type of nonobstructive coronary artery disease. However, the vasospasm causes severe narrowing. Coronary microvascular disease in small arteries and obstructive coronary artery disease in large arteries. Figure A shows the small coronary artery network, which includes a normal artery and an artery with coronary microvascular disease.
Figure B shows a large coronary artery with plaque buildup. Read more. Read less. Risk Factors - Coronary Heart Disease. Environment and occupation. Your work life can also raise your risk if you: Come into contact with toxins, radiation, or other hazards Have a lot of stress at work Sit for long periods Work more than 55 hours a week, or work long, irregular, or night shifts that affect your sleep. Family history and genetics. Lifestyle habits.
Unhealthy lifestyle habits that are risk factors include the following: Being physically inactive , which can worsen other heart disease risk factors, such as high blood cholesterol and triglyceride levels, high blood pressure, diabetes and prediabetes, and overweight and obesity.
Not getting enough good quality sleep, including waking up often throughout the night, which may raise your risk of coronary heart disease. While you sleep, your blood pressure and heart rate fall. Your heart does not work as hard as it does when you are awake. As you begin to wake up, your blood pressure and heart rate increase to the usual levels when you are awake and relaxed.
Waking up suddenly can cause a sharp increase in blood pressure and heart rate, which has been linked to angina and heart attacks. Learn more in our How Sleep Works topic. Smoking tobacco or long-term exposure to secondhand smoke, which can damage the blood vessels.
Stress, which can trigger the tightening of your arteries, which increases your risk of coronary heart disease, especially coronary microvascular disease. Stress may also indirectly raise your risk of coronary heart disease if it makes you more likely to smoke or overeat foods high in fat and added sugars. Unhealthy eating patterns, such as consuming high amounts of saturated fats or trans fats and refined carbohydrates white bread, pasta, and white rice.
Other medical conditions. Part of the risk might be due to side effects of HIV treatments. Mental health conditions, including anxiety, depression, and posttraumatic stress disorder PTSD Metabolic syndrome Overweight and obesity Sleep disorders, such as sleep apnea or sleep deprivation and deficiency.
Race or ethnicity. Endometriosis , which raises the risk for heart disease in younger women Gestational diabetes , which can raise the risk for diabetes and metabolic syndrome even after pregnancy and the risk of developing coronary heart disease Polycystic ovary syndrome Preeclampsia , a condition that can happen during pregnancy and is linked to an increased lifetime risk for coronary heart disease Early menopause before age Screening and Prevention - Coronary Heart Disease.
Screening tests and results. To screen for coronary heart disease, your doctor will: Assess risk factors to help evaluate your risk of developing coronary heart disease Check blood pressure readings to see whether you have high blood pressure Calculate your body mass index and waist circumference to see whether you have an unhealthy weight Order blood tests to see whether you have high blood cholesterol, high blood triglycerides, or diabetes Screening usually occurs in a doctor's office, but sometimes screenings are done at health fairs, drugstores, or other places.
Risk calculators. Commonly used risk calculators might not accurately estimate risk in certain situations, such as if you: Are an ethnic minority, such as South Asian Are a woman who has had complications during pregnancy or had early menopause. Have metabolic syndrome or an inflammatory or autoimmune condition Have a family history of heart or blood vessel disease at a young age Take a statin to manage your cholesterol levels In these cases, your doctor may suggest other tests for coronary heart disease even if the ASCVD Risk Estimator says you are not at high risk.
How to prevent coronary heart disease. Signs and symptoms. An acute coronary event, such as a heart attack, may cause the following symptoms: Angina , which can feel like pressure, squeezing, burning, or tightness during physical activity. The pain or discomfort usually starts behind the breastbone, but it can also occur in the arms, shoulders, jaw, throat, or back.
The pain may feel like indigestion. Cold sweats Dizziness Light-headedness Nausea or a feeling of indigestion Neck pain Shortness of breath, especially with activity Sleep disturbances Weakness Women are somewhat less likely than men to experience chest pain. Instead, they are more likely to experience: Dizziness Fatigue Nausea Pressure or tightness in the chest Stomach pain Women are also more likely than men to have no symptoms of coronary heart disease.
Chronic long-term coronary heart disease can cause symptoms such as the following: Angina Shortness of breath with physical activity Fatigue Neck pain The symptoms may get worse as the buildup of plaque continues to narrow the coronary arteries. Coronary heart disease can cause serious complications, including the following: Acute coronary syndrome, including angina or heart attack Arrhythmia Heart failure Cardiogenic shock Sudden cardiac arrest Complications of coronary heart disease can be life-threatening and may lead to disability.
Diagnosis - Coronary Heart Disease. Medical history. Diagnostic tests and procedures. To diagnose coronary heart disease, your doctor may order some of the following tests. Blood tests to check the levels of cholesterol, triglycerides, sugar, lipoproteins , or proteins, such as C-reactive protein, that are a sign of inflammation.
An EKG also records the strength and timing of electrical signals as they pass through the heart. Coronary calcium scan to measure the amount of calcium in the walls of your coronary arteries. Buildup of calcium can be a sign of atherosclerosis, coronary artery disease, or coronary microvascular disease. This test is a type of cardiac CT scan.
Coronary calcium scans can also help assess coronary heart disease risk for people who smoke or for people who do not have heart symptoms. Stress tests to check how your heart works during physical stress. During stress testing, you walk or run on a treadmill or pedal a stationary bike to make your heart work hard and beat fast. If you have a medical problem that prevents you from exercising, your doctor may give you medicine to make your heart work hard, as it would during exercise.
To detect reduced blood flow to your heart muscle, while you exercise you will be monitored by ECG and possibly echocardiogram or a CT scan.
Cardiac MRI magnetic resonance imaging to detect tissue damage or problems with blood flow in the heart or coronary arteries. It can help your doctor diagnose coronary microvascular disease or nonobstructive or obstructive coronary artery disease. Cardiac positron emission tomography PET scanning to assess blood flow through the small coronary blood vessels and into the heart tissues.
This is a type of nuclear heart scan that can diagnose coronary microvascular disease. Coronary angiography to show the insides of your coronary arteries. To get the dye into your coronary arteries, your doctor will use a procedure called cardiac catheterization. This procedure is often used if other tests show that you are likely to have coronary artery disease. To diagnose coronary microvascular disease, your doctor will use coronary angiography with guidewire technology.
The sensors measure how easily blood flows through the small vessels. Usually, measurements are done before and after giving you medicine to enhance blood flow in your heart. Coronary computed tomographic angiography to show the insides of your coronary arteries rather than an invasive cardiac catheterization.
It is a noninvasive imaging test using CT scanning. Treatment - Coronary Heart Disease. Heart-healthy lifestyle changes. Your doctor may recommend that you adopt lifelong heart-healthy lifestyle changes, including: Aiming for a healthy weight. Greater amounts of weight loss can also improve blood pressure readings. Being physically active. Routine physical activity can help manage coronary heart disease risk factors such as high blood cholesterol, high blood pressure, or overweight and obesity.
Before starting any exercise program, ask your doctor what level of physical activity is right for you. A heart-healthy eating plan includes fruits, vegetables, and whole grains and limits saturated fats, trans fats, sodium salt , added sugars, and alcohol.
Managing stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Quitting smoking. Although these resources focus on heart health, they include basic information about how to quit smoking. Talk to your doctor if you vape. There is scientific evidence that nicotine and flavorings found in vaping products may damage your heart and lungs.
Get enough good-quality sleep. The recommended amount for adults is 7 to 9 hours of sleep a day. ACE inhibitors and beta blockers to help lower blood pressure and decrease the heart's workload.
Calcium channel blockers to lower blood pressure by allowing blood vessels to relax. Medicines to control blood sugar, such as empagliflozin, canagliflozin, and liraglutide, to help lower your risk for complications if you have coronary heart disease and diabetes. Metformin to control plaque buildup if you have diabetes.
Nitrates, such as nitroglycerin, to dilate your coronary arteries and relieve or prevent chest pain from angina. Ranolazine to treat coronary microvascular disease and the chest pain it may cause. Cholesterol-containing deposits plaques in your coronary arteries and inflammation are usually to blame for coronary artery disease. The coronary arteries supply blood, oxygen and nutrients to your heart. A buildup of plaque can narrow these arteries, decreasing blood flow to your heart.
Eventually, the reduced blood flow may cause chest pain angina , shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack. Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack.
But you can take steps to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact. If your coronary arteries narrow, they can't supply enough oxygen-rich blood to your heart — especially when it's beating hard, such as during exercise.
At first, the decreased blood flow may not cause any symptoms. As plaque continues to build up in your coronary arteries, however, you may develop the following coronary artery disease signs and symptoms:. Heart attack. A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. Women are somewhat more likely than men are to have less typical signs and symptoms of a heart attack, such as neck or jaw pain.
And they may have other symptoms such as shortness of breath, fatigue and nausea. If you think you're having a heart attack, immediately call or your local emergency number.
If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last option. If you have risk factors for coronary artery disease — such as high blood pressure, high cholesterol, tobacco use, diabetes, obesity a strong family history of heart disease — talk to your doctor. Your doctor may want to test you for coronary artery disease, especially if you have signs or symptoms of narrowed arteries.
If you have too many cholesterol particles in your blood, cholesterol may accumulate on your artery walls. Eventually, deposits called plaques may form. The deposits may narrow — or block — your arteries. These plaques can also burst, causing a blood clot to form. Facebook Twitter LinkedIn Syndicate.
Heart Disease Facts. Minus Related Pages. Percentages of all deaths caused by heart disease in by ethnicity, race, and sex. Get Email Updates. To receive email updates about this page, enter your email address: Email Address. Physical inactivity and obesity are the two risk factors affecting the most Americans. So, getting more physical activity and eating a balanced heart-healthy diet might be a good starting place for most Americans. A PDF of this entire section, including the sources and links below, is available here.
Find an Interventional Cardiologist. Heart Condition Centers. Who Is Affected by Cardiovascular Disease? Men and Women Heart disease is the leading cause of death for both men and women in the United States. Old and Young and In Between Heart disease can affect people of all ages.
Generally, the risk of cardiovascular disease increases as you age. All Socioeconomic Levels - Some More at Risk than Others Lower socioeconomic status is associated with an increase of chronic stress, which may lead to heart problems.
Americans with Heart Disease Risk Factors Many Americans are at risk for heart disease due to the risk factors in the following chart. State of disparities in cardiovascular health in the United States. March 15 ; Deaths: final data for Natl Vital Stat Rep. Sep 16 ;50 15
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