How coronary heart disease develops

Coronary arteries supply the heart muscle with oxygenated blood. Over time, fatty deposits including cholesterol can build up in the artery wall, forming plaques. This process is atherosclerosis. The plaque narrows the lumen, reducing blood flow through the coronary artery.

With reduced blood supply, the heart muscle receives less oxygen and glucose. If a coronary artery becomes completely blocked: often when a blood clot forms on a plaque: part of the heart muscle is deprived of oxygen and dies. This is a heart attack (myocardial infarction).

Risk factors

Risk factorHow it increases CHD risk
High-fat diet (especially saturated fat)Raises blood cholesterol, promoting plaque formation
SmokingDamages artery lining, making plaque formation more likely; carbon monoxide reduces oxygen-carrying capacity
Lack of exerciseContributes to obesity and higher blood pressure
ObesityAssociated with higher cholesterol and blood pressure
Genetic predispositionFamily history increases risk regardless of lifestyle
Stress and high blood pressureDamages artery walls over time

Treatment and prevention

Prevention focuses on lifestyle changes: reducing saturated fat intake, regular exercise, stopping smoking and maintaining a healthy body mass. Medical treatments include statins to lower blood cholesterol and stents: wire mesh tubes inserted into narrowed coronary arteries to hold them open and restore blood flow.

In severe cases, a coronary bypass operation grafts a blood vessel from another part of the body to bypass the blocked section, restoring blood supply to the heart muscle.