Coronary Artery Disease

National Library of Medicine

Arteriosclerosis, Coronary

Atherosclerosis, Coronary

CAD

Coronary Arteriosclerosis

Coronary atherosclerosis

Coronary artery disease (CAD) is the most common type of heart disease. It is the
leading cause of death in the United States in both men and women.

CAD happens when the arteries that supply blood to heart muscle become hardened and
narrowed. This is due to the buildup of cholesterol and other material, called
plaque, on their inner walls. This buildup is called atherosclerosis. As it grows,
less blood can flow through the arteries. As a result, the heart muscle can't get
the blood or oxygen it needs. This can lead to chest pain (angina) or a heart
attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts'
blood supply, causing permanent heart damage.

Over time, CAD can also weaken the heart muscle and contribute to heart failure and
arrhythmias. Heart failure means the heart can't pump blood well to the rest of the
body. Arrhythmias are changes in the normal beating rhythm of the heart.

NIH: National Heart, Lung, and Blood Institute

Coronary Artery Disease

Seniors

Blood, Heart and Circulation

Coronary artery disease (CAD) is the most common type of heart disease. It is the
leading cause of death in the United States in both men and women. CAD happens ...

LDL: The "Bad" Cholesterol

National Library of Medicine

Low-density lipoprotein

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your
body. Your liver makes cholesterol, and it is also in some foods, such as meat and
dairy products. Your body needs some cholesterol to work properly. But having too
much cholesterol in your blood raises your risk of coronary artery disease.

What are LDL and HDL?

There are two main types of cholesterol: LDL (bad) cholesterol and HDL (good)
cholesterol:
LDL stands for low-density lipoproteins. It is called the "bad" cholesterol because
a high LDL level leads to a buildup of cholesterol in your arteries.
HDL stands for high-density lipoproteins. It is called the "good" cholesterol
because it carries cholesterol from other parts of your body back to your liver.
Your liver then removes the cholesterol from your body.
How can a high LDL level raise my risk of coronary artery disease and other
diseases?
If you have a high LDL level, this means that you have too much LDL cholesterol in
your blood. This extra LDL, along with other substances, forms plaque. The plaque
builds up in your arteries; this is a condition called atherosclerosis.

Coronary artery disease happens when the plaque buildup is in the arteries of your
heart. It causes the arteries to become hardened and narrowed, which slows down or
blocks the blood flow to your heart. Since your blood carries oxygen to your heart,
this means that your heart may not be able to get enough oxygen. This can cause
angina (chest pain), or if the blood flow is completely blocked, a heart attack.

How do I know what my LDL level is?

A blood test can measure your cholesterol levels, including LDL. When and how often
you should get this test depends on your age, risk factors, and family history. The
general recommendations are:

For people who are age 19 or younger:

The first test should be between ages 9 to 11

Children should have the test again every 5 years
Some children may have this test starting at age 2 if there is a family history of
high blood cholesterol, heart attack, or stroke
For people who are age 20 or older:

Younger adults should have the test every 5 years

Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
What can affect my LDL level?
Things that can affect your LDL level include

Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol
level rise
Weight. Being overweight tends to raise your LDL level, lower your HDL level, and
increase your total cholesterol level
Physical Activity. A lack of physical activity can lead to weight gain, which can
raise your LDL level
Smoking.Cigarette smoking lowers your HDL cholesterol. Since HDL helps to remove
LDL from your arteries, if you have less HDL, that can contribute to you having a
higher LDL level.
Age and Gender. As women and men get older, their cholesterol levels rise. Before
the age of menopause, women have lower total cholesterol levels than men of the
same age. After the age of menopause, women's LDL levels tend to rise.
Genetics. Your genes partly determine how much cholesterol your body makes. High
cholesterol can run in families. For example, familial hypercholesterolemia (FH) is
an inherited form of high blood cholesterol.
Medicines. Certain medicines, including steroids, some blood pressure medicines,
and HIV/AIDS medicines, can raise your LDL level.
Other medical conditions. Diseases such as chronic kidney disease, diabetes, and
HIV/AIDS can cause a higher LDL level.
Race. Certain races may have an increased risk of high blood cholesterol. For
example, African Americans typically have higher HDL and LDL cholesterol levels
than whites.
What should my LDL level be?
With LDL cholesterol, lower numbers are better, because a high LDL level can raise
your risk for coronary artery disease and related problems:

LDL (Bad) Cholesterol LevelLDL Cholesterol CategoryLess than 100mg/dLOptimal100-

129mg/dLNear optimal/above optimal130-159 mg/dLBorderline high160-189 mg/dLHigh190
mg/dL and aboveVery HighHow can I lower my LDL level?
There are two main ways to lower your LDL cholesterol:

Therapeutic lifestyle changes (TLC). TLC includes three parts:

Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated
and trans fats that you eat. Examples of eating plans that can lower your
cholesterol include the Therapeutic Lifestyle Changes diet and the DASH eating
plan.
Weight Management. If you are overweight, losing weight can help lower your LDL
cholesterol.
Physical Activity. Everyone should get regular physical activity (30 minutes on
most, if not all, days).
Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough,
you may also need to take medicines. There are several types of cholesterol-
lowering drugs available, including statins. The medicines work in different ways
and can have different side effects. Talk to your health care provider about which
one is right for you. While you are taking medicines to lower your cholesterol, you
still should continue with the lifestyle changes.
Some people with familial hypercholesterolemia (FH) may receive a treatment called
lipoprotein apheresis. This treatment uses a filtering machine to remove LDL
cholesterol from the blood. Then the machine returns the rest of the blood back to
the person.

NIH: National Heart, Lung, and Blood Institute

Cholesterol, LDL

Blood, Heart and Circulation

Food and Nutrition

... cholesterol in your blood raises your risk of coronary artery disease.What are
LDL and HDL? There are two ... a high LDL level raise my risk of coronary artery
disease and other diseases? If you have a high ...

Heart Health Tests

National Library of Medicine

Cardiac Test

Heart Test

Cardiac Diagnostic Tests

Heart diseases are the number one killer in the U.S. They are also a major cause of
disability. If you do have a heart disease, it is important to find it early, when
it is easier to treat. Blood tests and heart health tests can help find heart
diseases or identify problems that can lead to heart diseases. There are several
different types of heart health tests. Your doctor will decide which test or tests
you need, based on your symptoms (if any), risk factors, and medical history.

Cardiac Catheterization
Cardiac catheterization is a medical procedure used to diagnose and treat some
heart conditions. For the procedure, your doctor puts a catheter (a long, thin,
flexible tube) into a blood vessel in your arm, groin, or neck, and threads it to
your heart. The doctor can use the catheter to

Do a coronary angiography. This involves putting a special type of dye in the

catheter, so the dye can flow through your bloodstream to your heart. Then your
doctor takes x-rays of your heart. The dye allows your doctor to see your coronary
arteries on the x-ray, and to check for coronary artery disease (plaque buildup in
the arteries).
Take samples of blood and heart muscle
Do procedures such as minor heart surgery or angioplasty, if your doctor finds that
you need it
Cardiac CT Scan
A cardiac CT (computed tomography) scan is a painless imaging test that uses x-rays
to take detailed pictures of your heart and its blood vessels. Computers can
combine these pictures to create a three-dimensional (3D) model of the whole heart.
This test can help doctors detect or evaluate

Coronary artery disease

Calcium buildup in the coronary arteries
Problems with the aorta
Problems with heart function and valves
Pericardial diseases
Before you have the test, you get an injection of contrast dye. The dye highlights
your heart and blood vessels in the pictures. The CT scanner is a large, tunnel-
like machine. You lie still on a table which slides you into the scanner, and the
scanner takes the pictures for about 15 minutes.

Cardiac MRI
Cardiac MRI (magnetic resonance imaging) is a painless imaging test that uses radio
waves, magnets, and a computer to create detailed pictures of your heart. It can
help your doctor figure out whether you have heart disease, and if so, how severe
it is. A cardiac MRI can also help your doctor decide the best way to treat heart
problems such as

Coronary artery disease

Heart valve problems
Pericarditis
Cardiac tumors
Damage from a heart attack
The MRI is a large, tunnel-like machine. You lie still on a table which slides you
into the MRI machine. The machine makes loud noises as it takes pictures of your
heart. It usually takes about 30-90 minutes. Sometimes before the test, you might
get an injection of contrast dye. The dye highlights your heart and blood vessels
in the pictures.

Chest X-Ray
A chest x-ray creates pictures of the organs and structures inside your chest, such
as your heart, lungs, and blood vessels. It can reveal signs of heart failure, as
well as lung disorders and other causes of symptoms not related to heart disease.

Coronary Angiography
Coronary angiography (angiogram) is a procedure that uses contrast dye and x-ray
pictures to look at the insides of your arteries. It can show whether plaque is
blocking your arteries and how severe the blockage is. Doctors use this procedure
to diagnose heart diseases after chest pain, sudden cardiac arrest, or abnormal
results from other heart tests such as an EKG or a stress test.
You usually have a cardiac catheterization to get the dye into your coronary
arteries. Then you have special x-rays while the dye is flowing through your
coronary arteries. The dye lets your doctor study the flow of blood through your
heart and blood vessels.

Echocardiography
Echocardiography, or echo, is a painless test that uses sound waves to create
moving pictures of your heart. The pictures show the size and shape of your heart.
They also show how well your heart's chambers and valves are working. Doctors use
an echo to diagnose many different heart problems, and to check how severe they
are.

For the test, a technician applies gel to your chest. The gel helps sound waves
reach your heart. The technician moves a transducer (wand-like device) around on
your chest. The transducer connects to a computer. It transmits ultrasound waves
into your chest, and the waves bounce (echo) back. The computer converts the echoes
into pictures of your heart.

Electrocardiogram (EKG), (ECG)

An electrocardiogram, also called an ECG or EKG, is a painless test that detects
and records your heart's electrical activity. It shows how fast your heart is
beating and whether its rhythm is steady or irregular.

An EKG may be part of a routine exam to screen for heart disease. Or you may get it
to detect and study heart problems such as heart attacks, arrhythmia, and heart
failure.

For the test, you lie still on a table and a nurse or technician attaches
electrodes (patches that have sensors) to the skin on your chest, arms, and legs.
Wires connect the electrodes to a machine that records your heart's electrical
activity.

Stress Testing
Stress testing looks at how your heart works during physical stress. It can help to
diagnose coronary artery disease, and to check how severe it is. It can also check
for other problems, including heart valve disease and heart failure.

For the test, you exercise (or are given medicine if you are unable to exercise) to
make your heart work hard and beat fast. While this is happening, you get an EKG
and blood pressure monitoring. Sometimes you may also have an echocardiogram, or
other imaging tests such as a nuclear scan. For the nuclear scan, you get an
injection of a tracer (a radioactive substance), which travels to your heart.
Special cameras detect the energy from the tracer to make pictures of your heart.
You have pictures taken after you exercise, and then after you rest.

NIH: National Heart, Lung, and Blood Institute

Diagnostic Techniques, Cardiovascular

Heart Function Tests

Blood, Heart and Circulation

... on the x-ray, and to check for coronary artery disease (plaque buildup in the
arteries). Take samples of ... This test can help doctors detect or evaluate
Coronary artery disease Calcium buildup in the coronary arteries Problems with ...

Heart Attack
National Library of Medicine

MI

Myocardial Infarction

Each year almost 800,000 Americans have a heart attack. A heart attack happens when
blood flow to the heart suddenly becomes blocked. Without the blood coming in, the
heart can't get oxygen. If not treated quickly, the heart muscle begins to die. But
if you do get quick treatment, you may be able to prevent or limit damage to the
heart muscle. That's why it's important to know the symptoms of a heart attack and
call 911 if you or someone else is having them. You should call, even if you are
not sure that it is a heart attack.

The most common symptoms in men and women are

Chest discomfort. It is often in center or left side of the chest. It usually lasts
more than a few minutes. It may go away and come back. It can feel like pressure,
squeezing, fullness, or pain. It also can feel like heartburn or indigestion.
Shortness of breath. Sometimes this is your only symptom. You may get it before or
during the chest discomfort. It can happen when you are resting or doing a little
bit of physical activity.
Discomfort in the upper body. You may feel pain or discomfort in one or both arms,
the back, shoulders, neck, jaw, or upper part of the stomach.
You may also have other symptoms, such as nausea, vomiting, dizziness, and
lightheadedness. You may break out in a cold sweat. Sometimes women will have
different symptoms then men. For example, they are more likely to feel tired for no
reason.

The most common cause of heart attacks is coronary artery disease (CAD). With CAD,
there is a buildup of cholesterol and other material, called plaque, on their inner
walls or the arteries. This is atherosclerosis. It can build up for years.
Eventually an area of plaque can rupture (break open). A blood clot can form around
the plaque and block the artery.

A less common cause of heart attack is a severe spasm (tightening) of a coronary

artery. The spasm cuts off blood flow through the artery.

At the hospital, health care providers make a diagnosis based on your symptoms,
blood tests, and different heart health tests. Treatments may include medicines and
medical procedures such as coronary angioplasty. After a heart attack, cardiac
rehabilitation and lifestyle changes can help you recover.

NIH: National Heart, Lung, and Blood Institute

Myocardial Infarction

Blood, Heart and Circulation

... The most common cause of heart attacks is coronary artery disease (CAD). With
CAD, there is a buildup of ... their inner walls or the arteries. This is
atherosclerosis. It can build up ... (tightening) of a coronary artery. The spasm
cuts off blood flow through ...

VLDL Cholesterol
National Library of Medicine

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your
body. Your liver makes cholesterol, and it is also in some foods, such as meat and
dairy products. Your body needs some cholesterol to work properly. But having too
much cholesterol in your blood raises your risk of coronary artery disease.

What is VLDL cholesterol?

VLDL stands for very-low-density lipoprotein. Your liver makes VLDL cholesterol and
releases it into your bloodstream. The VLDL particles carry triglycerides, another
type of fat, to your tissues. VLDL is similar to LDL cholesterol, but LDL carries
cholesterol to your tissues instead of triglycerides.

VLDL and LDL are "bad" cholesterols because they can contribute to the buildup of
plaque in your arteries. This buildup is called atherosclerosis. The plaque that
builds up is a sticky substance made up of fat, cholesterol, calcium, and other
substances found in the blood. Over time, the plaque hardens and narrows your
arteries. This limits the flow of oxygen-rich blood to your body. It can lead to
coronary artery disease and other heart diseases.

How do I know what my VLDL level is?

There isn't a way to directly measure your VLDL level. Instead, you will most
likely get a blood test to measure your triglyceride level. The lab can use your
triglyceride level to estimate what your VLDL level is. Your VLDL is about one-
fifth of your triglyceride level. However, estimating your VLDL this way does not
work if your triglyceride level is very high.

What should my VLDL level be?

Your VLDL level should be less than 30 mg/dL (milligrams per deciliter). Anything
higher than that puts you at risk for heart disease and stroke.

How can I lower my VLDL level?

Since VLDL and triglycerides are linked, you can lower VLDL level by lowering your
triglyceride level. You may be able to lower your triglycerides with a combination
of losing weight, diet, and exercise. It is important to switch to healthy fats,
and cut back on sugar and alcohol. Some people may also need to take medicines.

Cholesterol, VLDL

Blood, Heart and Circulation

Food and Nutrition

... cholesterol in your blood raises your risk of coronary artery disease.What is
VLDL cholesterol? VLDL stands for very- ... plaque in your arteries. This buildup
is called atherosclerosis. The plaque ... It can lead to coronary artery disease
and other heart diseases.How do ...

Angioplasty

National Library of Medicine

Balloon angioplasty

If you have coronary artery disease, the arteries in your heart are narrowed or
blocked by a sticky material called plaque. Angioplasty is a procedure to restore
blood flow through the artery.

You have angioplasty in a hospital. The doctor threads a thin tube through a blood
vessel in the arm or groin up to the involved site in the artery. The tube has a
tiny balloon on the end. When the tube is in place, the doctor inflates the balloon
to push the plaque outward against the wall of the artery. This widens the artery
and restores blood flow.

Doctors may use angioplasty to

Reduce chest pain caused by reduced blood flow to the heart

Minimize damage to heart muscle from a heart attack
Many people go home the day after angioplasty, and are able to return to work
within a week of coming home.

NIH: National Heart, Lung, and Blood Institute

Angioplasty

Blood, Heart and Circulation

Surgery and Rehabilitation

If you have coronary artery disease, the arteries in your heart are narrowed or
blocked by a sticky material called plaque. Angioplasty is a procedure ...

Coronary Artery Bypass Surgery

National Library of Medicine

Bypass Surgery

CABG

Coronary Artery Bypass Graft

In coronary artery disease (CAD), the arteries that supply blood and oxygen to your
heart muscle grow hardened and narrowed. You may try treatments such as lifestyle
changes, medicines, and angioplasty, a procedure to open the arteries. If these
treatments don't help, you may need coronary artery bypass surgery.

The surgery creates a new path for blood to flow to the heart. The surgeon takes a
healthy piece of vein from the leg or artery from the chest or wrist. Then the
surgeon attaches it to the coronary artery, just above and below the narrowed area
or blockage. This allows blood to bypass (get around) the blockage. Sometimes
people need more than one bypass.

The results of the surgery usually are excellent. Many people remain symptom-free
for many years. You may need surgery again if blockages form in the grafted
arteries or veins or in arteries that weren't blocked before. Lifestyle changes and
medicines may help prevent arteries from becoming clogged again.

NIH: National Heart, Lung, and Blood Institute

Coronary Artery Bypass

Blood, Heart and Circulation

Surgery and Rehabilitation

In coronary artery disease (CAD), the arteries that supply blood and oxygen to your
heart muscle grow hardened and narrowed. You ...

HDL: The "Good" Cholesterol

National Library of Medicine

High-density lipoprotein

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your
body. Your liver makes cholesterol, and it is also in some foods, such as meat and
dairy products. Your body needs some cholesterol to work properly. But having too
much cholesterol in your blood raises your risk of coronary artery disease.

What are HDL and LDL?

There are two main types of cholesterol: HDL (good) cholesterol and LDL (bad)
cholesterol:

HDL stands for high-density lipoproteins. It is called the "good" cholesterol

because it carries cholesterol from other parts of your body back to your liver.
Your liver then removes the cholesterol from your body.
LDL stands for low-density lipoproteins. It is called the "bad" cholesterol because
a high LDL level leads to a buildup of cholesterol in your arteries.
How do I know what my HDL level is?
A blood test can measure your cholesterol levels, including HDL. When and how often
you should get this test depends on your age, risk factors, and family history. The
general recommendations are:

For people who are age 19 or younger:

The first test should be between ages 9 to 11

Children should have the test again every 5 years
Some children may have this test starting at age 2 if there is a family history of
high blood cholesterol, heart attack, or stroke
For people who are age 20 or older:

Younger adults should have the test every 5 years

Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
What should my HDL level be?
With HDL cholesterol, higher numbers are better, because a high HDL level can lower
your risk for coronary artery disease and stroke. How high your HDL should be
depends on your age and sex:

GroupHealthy HDL LevelAge 19 or youngerMore than 45mg/dlMen age 20 or olderMore

than 40mg/dlWomen age 20 or olderMore than 50mg/dlHow can I raise my HDL level?
If your HDL level is too low, lifestyle changes may help. These changes may also
help prevent other diseases, and make you feel better overall:

Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of
bad fats. This means limiting saturated fats, which include full-fat milk and
cheese, high-fat meats like sausage and bacon, and foods made with butter, lard,
and shortening. You should also avoid trans fats, which may be in some margarines,
fried foods, and processed foods like baked goods. Instead, eat unsaturated fats,
which are found in avocado, vegetable oils like olive oil, and nuts. Limit
carbohydrates, especially sugar. Also try to eat more foods naturally high in
fiber, such as oatmeal and beans.
Stay at a healthy weight. You can boost your HDL level by losing weight, especially
if you have lots of fat around your waist.
Exercise. Getting regular exercise can raise your HDL level, as well as lower your
LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on
most, if not all, days.
Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level.
If you are a smoker, ask your health care provider for help in finding the best way
for you to quit. You should also try to avoid secondhand smoke.
Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are
needed to confirm that. What we do know is that too much alcohol can make you gain
weight, and that lowers your HDL level.
Some cholesterol medicines, including certain statins, can raise your HDL level, in
addition to lowering your LDL level. Health care providers don't usually prescribe
medicines only to raise HDL. But if you have a low HDL and high LDL level, you
might need medicine.

What else can affect my HDL level?

Taking certain medicines can lower HDL levels in some people. They include

Beta blockers, a type of blood pressure medicine

Anabolic steroids, including testosterone, a male hormone
Progestins, which are female hormones that are in some birth control pills and
Hormone replacement therapy
Benzodiazepines, sedatives that are often used for anxiety and insomnia
If you are taking one of these and you have a very low HDL level, ask your provider
if you should continue to take them.

Diabetes can also lower your HDL level, so that gives you another reason to manage
your diabetes.

Cholesterol, HDL

Blood, Heart and Circulation

Food and Nutrition

... cholesterol in your blood raises your risk of coronary artery disease.What are
HDL and LDL? There are two ... high HDL level can lower your risk for coronary
artery disease and stroke. How high your HDL should be ...

How to Prevent Heart Disease

National Library of Medicine

Heart Disease Prevention

Heart disease is the leading cause of the death in the United States. It is also a
major cause of disability. There are many things that can raise your risk for heart
disease. They are called risk factors. Some of them you cannot control, but there
are many that you can control. Learning about them can lower your risk of heart
disease.

What are the heart disease risk factors that I cannot change?
Age. Your risk of heart disease increases as you get older. Men age 45 and older
and women age 55 and older have a greater risk.
Gender. Some risk factors may affect heart disease risk differently in women than
in men. For example, estrogen provides women some protection against heart disease,
but diabetes raises the risk of heart disease more in women than in men.
Race or ethnicity. Certain groups have higher risks than others. African Americans
are more likely than whites to have heart disease, while Hispanic Americans are
less likely to have it. Some Asian groups, such as East Asians, have lower rates,
but South Asians have higher rates.
Family history. You have a greater risk if you have a close family member who had
heart disease at an early age.
What can I do to lower my risk of heart disease?
Fortunately, there are many things you can do to reduce your chances of getting
heart disease:

Control your blood pressure.High blood pressure is a major risk factor for heart
disease. It is important to get your blood pressure checked regularly - at least
once a year for most adults, and more often if you have high blood pressure. Take
steps, including lifestyle changes, to prevent or control high blood pressure.
Keep your cholesterol and triglyceride levels under control. High levels of
cholesterol can clog your arteries and raise your risk of coronary artery disease
and heart attack. Lifestyle changes and medicines (if needed) can lower your
cholesterol. Triglycerides are another type of fat in the blood. High levels of
triglycerides may also raise the risk of coronary artery disease, especially in
women.
Stay at a healthy weight. Being overweight or having obesity can increase your risk
for heart disease. This is mostly because they are linked to other heart disease
risk factors, including high blood cholesterol and triglyceride levels, high blood
pressure, and diabetes. Controlling your weight can lower these risks.
Eat a healthy diet. Try to limit saturated fats, foods high in sodium, and added
sugars. Eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is
an example of an eating plan that can help you to lower your blood pressure and
cholesterol, two things that can lower your risk of heart disease.
Get regular exercise. Exercise has many benefits, including strengthening your
heart and improving your circulation. It can also help you maintain a healthy
weight and lower cholesterol and blood pressure. All of these can lower your risk
of heart disease.
Limit alcohol. Drinking too much alcohol can raise your blood pressure. It also
adds extra calories, which may cause weight gain. Both of those raise your risk of
heart disease. Men should have no more than two alcoholic drinks per day, and women
should not have more than one.
Don't smoke. Cigarette smoking raises your blood pressure and puts you at higher
risk for heart attack and stroke. If you do not smoke, do not start. If you do
smoke, quitting will lower your risk for heart disease. You can talk with your
health care provider for help in finding the best way for you to quit.
Manage stress.Stress is linked to heart disease in many ways. It can raise your
blood pressure. Extreme stress can be a "trigger" for a heart attack. Also, some
common ways of coping with stress, such as overeating, heavy drinking, and smoking,
are bad for your heart. Some ways to help manage your stress include exercise,
listening to music, focusing on something calm or peaceful, and meditating.
Manage diabetes. Having diabetes doubles your risk of diabetic heart disease. That
is because over time, high blood sugar from diabetes can damage your blood vessels
and the nerves that control your heart and blood vessels. So, it is important to
get tested for diabetes, and if you have it, to keep it under control.
Make sure that you get enough sleep. If you don't get enough sleep, you raise your
risk of high blood pressure, obesity, and diabetes. Those three things can raise
your risk for heart disease. Most adults need 7 to 9 hours of sleep per night. Make
sure that you have good sleep habits. If you have frequent sleep problems, contact
your health care provider. One problem, sleep apnea, causes people to briefly stop
breathing many times during sleep. This interferes with your ability to get a good
rest and can raise your risk of heart disease. If you think you might have it, ask
your doctor about having a sleep study. And if you do have sleep apnea, make sure
that you get treatment for it.

Heart Diseases

Blood, Heart and Circulation

Wellness and Lifestyle

... clog your arteries and raise your risk of coronary artery disease and heart
attack. Lifestyle changes and medicines (if ... of triglycerides may also raise the
risk of coronary artery disease, especially in women. Stay at a healthy weight. ...

Cholesterol

National Library of Medicine

Familial Combined Hyperlipidemia

Familial Dysbetalipoproteinemia

Familial Hypercholesterolemia

Hypercholesterolemia

Hyperlipidemia

Hyperlipoproteinemia

What is cholesterol?

Cholesterol is a waxy, fat-like substance that's found in all the cells in your
body. Your body needs some cholesterol to make hormones, vitamin D, and substances
that help you digest foods. Your body makes all the cholesterol it needs.
Cholesterol is also found in foods from animal sources, such as egg yolks, meat,
and cheese.

If you have too much cholesterol in your blood, it can combine with other
substances in the blood to form plaque. Plaque sticks to the walls of your
arteries. This buildup of plaque is known as atherosclerosis. It can lead to
coronary artery disease, where your coronary arteries become narrow or even
blocked.

What are LDL, HDL, and VLDL?

There are different types of cholesterol:

HDL stands for high-density lipoprotein. It is called the "good" cholesterol

because it carries cholesterol from other parts of your body back to your liver.
Your liver then removes the cholesterol from your body.
LDL stands for low-density lipoprotein. It is called the "bad" cholesterol because
a high LDL level leads to the buildup of plaque in your arteries.
VLDL stands for very low-density lipoprotein. It is also a "bad" cholesterol
because it too contributes to the buildup of plaque in your arteries. But VLDL and
LDL are different; VLDL carries triglycerides and LDL carries cholesterol.
What causes high cholesterol?
The most common cause of high cholesterol is an unhealthy lifestyle. This can
include

Unhealthy eating habits, such as eating lots of bad fats. One type, saturated fat,
is found in some meats, dairy products, chocolate, baked goods, and deep-fried and
processed foods. Another type, trans fat, is in some fried and processed foods.
Eating these fats can raise your LDL (bad) cholesterol.
Lack of physical activity, with lots of sitting and little exercise. This lowers
your HDL (good) cholesterol.
Smoking, which lowers HDL cholesterol, especially in women. It also raises your LDL
cholesterol.
Genetics may also cause people to have high cholesterol. For example, familial
hypercholesterolemia (FH) is an inherited form of high cholesterol. Other medical
conditions and certain medicines may also cause high cholesterol.

What can raise my risk of high cholesterol?

A variety of things can raise your risk for high cholesterol:

Age. Your cholesterol levels tend to rise as you get older. Even though it is less
common, younger people, including children and teens, can also have high
cholesterol.
Heredity. High blood cholesterol can run in families.
Weight. Being overweight or having obesity raises your cholesterol level.
Race. Certain races may have an increased risk of high cholesterol. For example,
African Americans typically have higher HDL and LDL cholesterol levels than whites.
Weight. Being overweight or having obesity raises your cholesterol level.
What health problems can high cholesterol cause?
If you have large deposits of plaque in your arteries, an area of plaque can
rupture (break open). This can cause a blood clot to form on the surface of the
plaque. If the clot becomes large enough, it can mostly or completely block blood
flow in a coronary artery.

If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, it can
cause angina (chest pain) or a heart attack.

Plaque also can build up in other arteries in your body, including the arteries
that bring oxygen-rich blood to your brain and limbs. This can lead to problems
such as carotid artery disease, stroke, and peripheral arterial disease.

How is high cholesterol diagnosed?

There are usually no signs or symptoms that you have high cholesterol. There is a
blood test to measure your cholesterol level. When and how often you should get
this test depends on your age, risk factors, and family history. The general
recommendations are:

For people who are age 19 or younger:

The first test should be between ages 9 to 11

Children should have the test again every 5 years
Some children may have this test starting at age 2 if there is a family history of
high blood cholesterol, heart attack, or stroke
For people who are age 20 or older:

Younger adults should have the test every 5 years

Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
How can I lower my cholesterol?
You can lower your cholesterol through heart-healthy lifestyle changes. They
include a heart-healthy eating plan, weight management, and regular physical
activity.
If the lifestyle changes alone do not lower your cholesterol enough, you may also
need to take medicines. There are several types of cholesterol-lowering drugs
available, including statins. If you take medicines to lower your cholesterol, you
still should continue with the lifestyle changes.

Some people with familial hypercholesterolemia (FH) may receive a treatment called
lipoprotein apheresis. This treatment uses a filtering machine to remove LDL
cholesterol from the blood. Then the machine returns the rest of the blood back to
the person.

NIH: National Heart, Lung, and Blood Institute

Cholesterol

Hypercholesterolemia

Blood, Heart and Circulation

Food and Nutrition

... mostly or completely block blood flow in a coronary artery. If the flow of ...
blood back to the person. NIH: National Heart, Lung, and Blood Institute