Q. What is heart disease?
A. Coronary heart disease, also known as coronary artery disease (CAD) and ischemic heart disease, is a disease of the heart's blood vessels that, if untreated, can cause heart attacks. Like any muscle, the heart needs a constant supply of oxygen and nutrients that are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged and cannot supply enough blood to the heart, the result is coronary heart disease (CHD).
Q. What causes heart disease?
A. Coronary heart disease starts with atherosclerosis, a process in which fatty substances build up inside the walls of blood vessels. Blood components also stick on the surface inside vessel walls making the vessels narrower and eventually "hardened" and less flexible. The buildup, or "plaque," may break apart, which can further limit blood flow. The buildup and narrowing proceed gradually and result in decreasing blood flow, followed by CHD symptoms.
Q. What are the symptoms?
A. When blood flows more slowly at the site of narrowing, it can become "sticky" and eventually form a clot. This blood clot can narrow the opening of the artery even further, which can reduce blood flow to the heart, leading to chest pain, or angina. If blood flow is nearly or completely blocked, a heart attack can occur.
Q. What are heart attack warning signs?
A. The warning signs are different in women than men. According to WomenHeart, The National Coalition for Women with Heart Disease, heart attack warning signs for women include:
- chest discomfort, pain, squeezing, burning or mild to severe pressure in the center of your chest that lasts more than a few minutes or comes and goes
- upper-body discomfort in one or both arms, back, neck, jaw or stomach
- shortness of breath, with or without chest discomfort
- dizziness, lightheadedness or fainting, nausea and vomiting or cold sweats
- feelings of anxiety, fatigue or weakness—unexplained or when you are exerting yourself
Q. Am I at risk?
A. Over the last two decades, researchers have unearthed many risk factors for developing cardiovascular diseases. These include:
- high cholesterol
- high blood pressure (also called hypertension)
- age (postmenopausal women are at increased risk)
- metabolic syndrome, which is a combination of three or more of these factors: abdominal obesity, high blood pressure, glucose intolerance (also called prediabetes), high triglycerides combined with low good (HDL) cholesterol
- homocysteine, an amino acid normally found in the body that may be a marker
- C-reactive protein, a sign of inflammation that may raise your heart disease risk
- pregnancy complications such as preeclampsia, gestational diabetes and pregnancy-induced hypertension
- systemic autoimmune diseases such as lupus and rheumatoid arthritis
Q. What can I do to lower my risk?
A. Here's what you can do to reduce your risks for developing heart disease:
- Quit smoking.
- Lower your blood pressure to 120/80 mm Hg, with lifestyle changes or with medication if necessary.
- Lower your blood cholesterol levels (LDL less than 100 mg/dL; HDL more than 50 mg/dL; triglycerides less than 150 mg/dL; and non–HDL-C [total cholesterol minus HDL cholesterol] less than 130 mg/dL).
- Lose weight—maintain or achieve a body mass index (BMI) between 18.5 and 24.9 and a waist circumference of less than 35 inches.
- Increase physical activity.
- Lower your risk factors for diabetes.
- Decrease stress.
- Follow a heart-healthy diet.