Coronary Heart Disease Causes

What is coronary heart disease?

Coronary heart disease (CHD) can also be referred to as coronary artery disease or ischaemic heart disease. This is a form of heart disease in which the arteries of the heart are unable to supply the heart with adequate oxygenated blood, causing chest pain (angina) and breathlessness due to the poor pumping activity of the heart. CHD is a prevalent cardiac disease and the major cause of cardiovascular mortality.¹  


The symptoms of CHD differ from person to person. However, because many people have no symptoms, they are unaware that they have coronary heart disease until they experience chest discomfort (angina) or obstructed blood flow to the heart (heart attack).

Symptoms or warning signs of coronary heart disease include:

  • Chest pain (angina)
  • Chest tightness
  • Shortness of breath
  • Pain radiating to the neck, jaw, throat, upper belly, and back
  • Pain, weakness, and numbness in the arms or legs if the blood vessels are narrowed.

Most times, these symptoms are exacerbated by stressful activities or emotions and can be relieved by rest.  


The most common cause of coronary heart disease (CHD) is an accumulation of fatty plaques (atheroma) on the walls of the coronary arteries, leading to partial or total blockage of the arteries. This process is called atherosclerosis.

The risk factors of atherosclerosis include:

  • Smoking: Smoking is a significant risk factor for coronary heart disease. Both nicotine and carbon monoxide from smoking stress the heart by making it work harder. Other compounds in cigarette smoke can harm the walls of your coronary arteries, causing furring. Smoking greatly raises your chances of acquiring heart disease.
  • High Blood Pressure (Hypertension): High blood pressure is another major risk factor because it adds extra stress to the arterial walls. This can eventually damage the blood vessels and lead to increased plaque formation. High blood pressure increases the risk of atherosclerosis on its own, but it becomes extremely dangerous when coupled with other risk factors.
  • High cholesterol levels: Cholesterol is a fat that your liver produces from the saturated fats you consume. It is required for healthy cells, but an excess of it in the blood might lead to accumulation in the coronary arteries which eventually causes coronary heart disease.
  • High Lipoprotein levels: Lipoproteins are spherical particles of fat (lipids) and protein that pass through your blood vessels to cells all over your body. Lipoprotein levels are inherited from your parents and are produced in the liver. However, your diet still has a role to play in the level of lipoprotein in your body. There are two major types of lipoproteins, High-Density Lipoprotein(HDL) which is also termed “good cholesterol”, as it protects against heart attack and stroke, and Low-Density Lipoprotein, which is also termed “bad cholesterol”, as it increases the risk of coronary heart disease by increasing the rate of narrowing of the coronary arteries because of its sticky nature which makes it easily held to the walls of the arteries.
  • Lack of regular exercise: Physical inactivity is thought to account for around 35% of coronary heart disease death in the US. This shows that lack of exercise is also a major risk factor for developing coronary heart disease. Reduced physical activities also lead to the build-up of fat plaques in the arteries.
  • Diabetes mellitus: Diabetes increases the risk of cardiovascular diseases. If you have high blood sugar levels (hyperglycemia) for an extended length of time, even if they are slightly elevated, your blood vessels might get damaged, leading to major cardiac issues. This is because your body cannot adequately utilize all of this sugar, more of it adheres to your red blood cells and accumulates in your blood. This build-up can clog and compromise the blood vessels that transport blood to and from your heart, depriving it of oxygen and nutrition.
  • Obesity: Obesity or being overweight is an independent risk factor for developing coronary heart disease and worsening the disease. Studies have reported that more than 80 percent of people with coronary heart disease are obese or overweight.² Excess weight might cause fat material to accumulate in your blood vessels, which can lead to clogging and damage of your blood vessels. Obesity can also increase the risk of other risk factors such as diabetes, increase cholesterol, and hypertension.
  • Genetics: Coronary heart disease (CHD) has significant genetic bases that are comparable to environmental variables. The heritability of CHD has been said to be more than 40%³, therefore if one’s parent has CHD, there is a high probability that one may have also, due to several encoding genes passed from your parents


Coronary heart disease is a common disease and the major cause of cardiovascular mortality. Symptoms range from mild to severe, with chest pain and tightness being early symptoms of the disease. Risk factors of the disease include genetic, environmental, and lifestyle factors.


  1. Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018 Mar 20;137(12):e67–492.
  2. Ades PA, Savage PD. Obesity in coronary heart disease: An unaddressed behavioral risk factor. Prev Med. 2017 Nov;104:117–9.
  3. McPherson R, Tybjaerg-Hansen A. Genetics of coronary artery disease. Circ Res. 2016 Feb 19;118(4):564–78.

Innocent Chijioke

Bachelor of Medicine, Bachelor of Surgery - MBBS, Medicine, University of IbadanUniversity of Ibadan, Nigeria

Innocent Dike is a final-year medical student at the University of Ibadan, Nigeria. He has more than two years of experience in research and health blog article writing. He serves as an ambassador for i-medics, where he trains his peers on blog article writing. presents all health information in line with our terms and conditions. It is essential to understand that the medical information available on our platform is not intended to substitute the relationship between a patient and their physician or doctor, as well as any medical guidance they offer. Always consult with a healthcare professional before making any decisions based on the information found on our website.
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