What are the risk factors for coronary artery disease?

A risk of coronary artery disease can be diagnosed through routine checkups. A blood test can indicate high levels of cholesterol. A check of blood pressure can reveal unhealthy levels. The presence of common symptoms such as chest pain or shortness of breath can also point to the presence of the condition. If any or all of these risk factors are present, further tests of the heart can confirm the diagnosis.
J J. Marshall, MD
J J. Marshall, MD on behalf of SCAI
Cardiology (Cardiovascular Disease)
Some heart disease risk factors are simply part of who we are, and cannot be changed. But many risk factors can be improved by following the treatment prescribed by your doctor and by making healthy lifestyle choices. That means you have the power to reduce your risk of heart disease.

Heart disease risk factors include the following:
  • Age. The risk of cardiovascular disease increases as you age. 
  • Gender. Men are more likely to develop heart disease than women, but that difference begins to disappear after women go through menopause.
  • Family history. Your risk of heart disease is approximately doubled if a parent or a brother or sister developed heart disease early in life.
  • Smoking. When you smoke, you expose your heart and blood vessels to nicotine, carbon monoxide and other harmful substances contained in smoke that can damage blood vessels.
  • High cholesterol levels. High levels of LDL cholesterol - the so-called bad cholesterol - can increase the build-up of plaque in the arteries of the heart. It is also unhealthy to have low levels of HDL, or "good" cholesterol. 
  • High blood pressure. If your blood pressure is above 140/90 mmHg for long periods of time, it can damage your blood vessels.
  • Diabetes. High blood sugar levels can damage the blood vessels throughout the body, making it more likely that atherosclerotic plaques will develop.
  • Being overweight or obese. Carrying around too much body weight not only puts a strain on your heart, it also makes it more difficult to control high blood pressure, high cholesterol levels, and diabetes.
  • Physical inactivity. A lack of exercise weakens your muscles and makes it harder to control several other heart disease risk factors, including blood pressure, cholesterol levels, diabetes, obesity and stress.
  • Metabolic syndrome. The term metabolic syndrome is used to describe a cluster of traits that, together, increase the risk for developing heart disease. These traits include high blood sugar, high blood pressure, low levels of "good" HDL cholesterol, high blood levels of fats known as triglycerides, and excess body weight, particularly in the belly area.
  • Stress. High levels of stress in your life, or a tendency to often feel angry, have also been linked to an increased risk for heart disease.
  • High levels of C-reactive protein. CRP is produced by the body in response to infection or inflammation. If your CRP levels are high, your risk of having a heart attack is increased.
Johns Hopkins Medicine
In coronary artery disease (CAD), narrowed coronary arteries limit the supply of blood to the heart muscle. Problems still tend to arise during moments of exertion, even if the arteries aren't extensively narrow because the arteries are unable to meet the heart's increased oxygen requirements. However, as the disease worsens, the narrowed arteries may starve the heart muscle of oxygen during periods of normal activity, or even while you&re resting.
  • Smoking promotes the development of plaque in the arteries. Also, by increasing the amount of carbon monoxide in the bloodstream and decreasing the amount of oxygen available to the heart, smoking increases the likelihood of angina.
  • High blood cholesterol levels lead to coronary artery disease.
  • High blood pressure predisposes one to CAD.
  • People with diabetes are at greater risk for atherosclerosis.
  • Obesity may also promote atherosclerosis.
  • Lack of exercise may encourage atherosclerosis.
  • Men are at greater risk than women for coronary artery disease, although the risk for postmenopausal women approaches that of men as estrogen production decreases with menopause. Ongoing studies will determine whether this risk may be partly offset by estrogen replacement therapy.
  • Women over age 35 who take oral contraceptives and smoke cigarettes have a higher risk of atherosclerosis.
  • A family history of premature heart attacks is associated with greater CAD risk.
  • A spasm of the muscular layer of the arterial walls may cause an artery to contract and produce angina. Spasms may be induced by smoking, extreme emotional stress or exposure to cold air.
Risk factors for coronary artery disease include:
  • high blood pressure
  • high LDL (low-density lipoprotein) (bad) cholesterol
  • low HDL (high-density lipoprotein) (good) cholesterol
  • smoking
  • diabetes
  • obesity
Having a sedentary lifestyle (limited activity or exercise) can increase the risk of developing coronary artery disease because it often leads to some of the conditions listed above.

The risk for heart disease also grows as people age due to genetic (things that run in families) or lifestyle factors that cause plaque to build up in the arteries.

If a person's father or brother was diagnosed with heart disease before age 55, or if the person's mother or sister was diagnosed before age 65, that person has a greater risk of being diagnosed with heart disease.

This content originally appeared online in "The Patient Guide to Heart, Lung, and Esophageal Surgery" from the Society of Thoracic Surgery.
Your heart contains coronary arteries that can become diseased when cholesterol builds up to form plaque in the lining of the artery. The risk factors for coronary artery disease are:
  • gender
  • age
  • family history
  • smoking
  • high blood pressure
  • high fat and cholesterol diet
  • excessive alcohol intake
  • overweight
  • lack of exercise
  • diabetes
Anthony L. Komaroff, MD
Internal Medicine
The vast majority of people who develop coronary artery disease have at least one major risk factor. Some of them you can't change, such as your age, gender, and genes. Yet there are many risk factors you can control. The key ones are your diet, exercise, and smoking. Making positive lifestyle choices like eating a healthy diet, exercising regularly, and not smoking will help reduce your risk for heart disease and help address other health problems (such as diabetes and high blood pressure) that raise your risk of heart disease.

There's yet another range of issues that falls somewhere in between: psychological factors, which include stress, depression, anxiety, neuroticism, and anger. On one hand, it might be difficult to control many of the events in your life that cause stress or hardship. On the other hand, you do have a certain degree of control over how you respond to those stresses.
David K. Singh, MD
Cardiology (Cardiovascular Disease)
Risk factors for coronary disease or heart disease include: 
  • Age. The most important risk factor for heart disease is age. Things can start to fail as people age.
  • Overweight or obesity.
  • Unhealthy diet.
  • Lack of exercise.
  • Smoking. Smoking is one of the biggest modifiable risk factors and is one of the leading causes of heart disease.
  • High blood pressure. People should see their healthcare provider regularly to be screened and treated for high blood pressure, which can be a silent killer.
  • Diabetes. People should be screened for diabetes, which can cause problems for the heart down the line.
Heart disease is the leading cause of death in American men and women. According to the Centers for Disease Control (CDC), heart disease kills about 600,000 people in the United States each year. Yet, many may continue to underestimate their risk.

Risk factors for heart disease include:
  • your age (55 or older for women)
  • your family history (If your mother or sister had heart disease before age 65 or father or brother had heart disease before age 55, then you are at greater risk for heart disease.)
  • smoking tobacco
  • being sedentary
  • being at an unhealthy weight (more than 20% over ideal body weight)
  • having high blood pressure (hypertension), or a blood pressure reading of 140/90 or greater
  • having high LDL (bad) cholesterol: greater than 100 milligrams per deciliter (mg/dL); and/or low HDL (good) cholesterol: less than 50 mg/dL for women or less than 40 mg/dL for men
  • having prediabetes or diabetes
Penn Medicine
There are many known risk factors for coronary heart disease. Some are controllable, but others are not. Risk factors you can control include:
  • Heart-related disorders such as high cholesterol, high blood pressure and diabetes
  • Weight
  • Smoking
  • Physical inactivity
  • Diet
  • Stress 
Risk factors you cannot control include:
  • Family history
  • Gender
  • Age
There are many known risk factors, some of which you can control. Those include high blood cholesterol, high blood pressure, diabetes and pre-diabetes, being overweight or obese, smoking and lack of physical activity or not exercising regularly.

The risk factors you can't control are age, gender and a family history of heart disease.

Coronary heart disease is the No. 1 cause of death for both men and women, but many of these risk factors can be minimized through dietary changes, regular exercise, weight loss and medication if needed.
Cardiac risk factors are conditions or behaviors that increase your chance of developing coronary disease or heart disease. The major cardiac risk factors can be divided into two groups:
  • Factors you cannot change, including age, sex, family history of heart disease, and a personal history of heart problems
  • Factors you can change, including high blood pressure, high blood cholesterol, smoking, high blood glucose (sugar), diabetes, physical inactivity, and excess weight

Continue Learning about Heart Disease

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Heart disease is the number one killer of adults in the United States. In fact, one in every three deaths is from heart disease and stroke, equal to 2,200 deaths per day. Taking care of your heart is essential for a long life. You ...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.