What Is Coronary Artery Disease—and Can It Be Prevented?

A healthy lifestyle—the earlier in life, the better—is our best defense against coronary artery disease, the leading cause of heart attack.

coronary artery disease

CAD is blockage in one or more of your coronary arteries. Usually, these blockages are plaques, which are hardened deposits of cholesterol and other materials. (See our sidebar on how to control your cholesterol levels.)

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You may have heard the term “heart disease” before as a risk factor for a heart attack. There are many types of heart diseases, but the one that ranks as the leading cause of heart attack is known as coronary artery disease, or CAD.

A coronary artery is an artery in the heart that delivers blood to the heart muscle. All of your muscles need a steady supply of oxygen-rich blood, and your heart is no different. Your heart beats about 100,000 times per day, which is quite a workout for any muscle. So keeping blood flowing steadily to that hard-working pump is critical to your health.

How CAD Develops

Though coronary artery disease causes most of its harm in older adults, CAD actually starts when we’re young and healthy. In simplest terms, CAD is blockage in one or more of your coronary arteries. Usually, these blockages are plaques, which are hardened deposits of cholesterol and other materials.

The accumulation of plaque is a condition called atherosclerosis. You may know it by another term: hardening of the arteries. That’s because plaque-filled arteries tend to become stiffer and less able to expand and constrict.

When blockage becomes too severe, blood flow through the artery decreases and can even stop altogether if the plaque is too great. This is coronary artery disease.

When the heart muscle doesn’t get enough oxygen it can hurt… a lot. It’s no different than a muscle in your arm or leg that doesn’t receive healthy circulation. Chest pain that results from poor blood flow in the coronary arteries is known as angina. When the flow of blood is completely blocked or even mostly blocked, you can experience a heart attack. During a heart attack, your heart muscle still pumps, though it can beat weakly. Even worse, heart tissue can die without health blood flow.(See also our post “Mild Heart Attack Symptoms: What Do They Mean?“)

But plaques don’t form overnight. “Coronary artery disease develops slowly, usually over decades, so the good news is that we have a huge window of opportunity for prevention, through a good lifestyle and healthy habits,” says Seth Martin, MD, of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.

Preventing Coronary Artery Disease

So what are the healthy habits that can keep your heart pumping mightily into old age?

They start with controlling your low-density lipoprotein (LDL) cholesterol and your high-density lipoprotein (HDL) levels. High LDL cholesterol is a leading risk factor for heart attack and stroke, because it’s the type of cholesterol that can gather in plaques along your artery walls. So keeping LDL low (aim for levels of under 100 mg/dL) is ideal. HDL cholesterol actually helps remove LDL from your system, so unlike LDL, you want your HDL numbers to be high (at least 60 mg/dL).



In committing to lower your LDL (“bad”) cholesterol level and improving your HDL (“good”) cholesterol, learn all you can about the topic. Our post “What Is a Normal Cholesterol Level?” offers an easy-to-understand explanation.

The following posts describe scientifically proven ways to control cholesterol levels—ways that can become part of a healthy lifestyle:

For some people, medications are necessary to manage your cholesterol levels. But those numbers are also affected by some more healthy habits. They include:

  • No smoking
  • Regular exercise
  • A diet low in saturated fat
  • Maintaining a health weight
  • Avoiding type 2 diabetes, or at least managing your blood sugar levels

“Research shows that the best preventive diets include a high intake of vegetables, fruits, whole grains, and fiber, and low intake of animal and dairy fat, sugar, and processed carbohydrates,” explains cardiologist Eugenia Gianos, MD, co-clinical director of the Center for the Prevention of Cardiovascular Disease at New York University Langone Medical Center.

As for exercise, any activity that raises your heart rate will help preserve heart health.

The more risk factors you have, such as high LDL, a sedentary lifestyle, obesity, and smoking, the greater your risk of a heart attack, explains Howard Weintraub, MD, co-clinical director of the Center for the Prevention of Cardiovascular Disease at New York University Langone Medical Center. “Each risk factor has an additive effect on the others.”

Non-Manageable Risk Factors

Of course, living a heart-healthy lifestyle is your best strategy for preventing coronary artery disease. But CAD has some risk factors that are beyond your control. These include advancing age and a family history of heart disease.

But if you can establish a pattern of healthy eating, getting regular physical activity and working with your doctor to control your cholesterol, blood pressure, blood sugar and weight, you may be able to protect yourself from the factors outside of your control.

And because CAD is a lifelong process, don’t hesitate to talk with your doctor about preventive steps you can take at any age to keep that valuable, hard-working pump in tip-top shape.

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Jay Roland

Jay Roland has been executive editor of Massachusetts General Hospital’s Mind, Mood & Memory since 2017. Previously, he held the same position with Cleveland Clinic’s Heart Advisor, since 2007. In … Read More

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