Coronary artery disease

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risk factors

Cardiovascular risk factors include both modifiable and non-modifiable factors. Download our free blood pressure monitoring chart to track your readings for discussion with your healthcare provider.

As we age, our risk of developing cardiovascular disease tends to increase, due to a variety of factors. Among these factors is the natural increase in blood pressure that occurs with age, which can put additional strain on the heart and blood vessels over time. Other contributing factors may include changes in cholesterol levels, the development of insulin resistance, and the accumulation of plaque in the arteries. However, by making lifestyle changes and working with healthcare professionals to manage risk factors, it is possible to reduce the risk of cardiovascular disease and maintain good heart health as we age.

Men are at a higher risk of developing cardiovascular diseases (CVDs) than women, in part due to biological differences. However, women's risk of developing CVDs increases after menopause due to hormonal changes that can lead to changes in blood vessel function and an increase in LDL cholesterol levels. Despite these risks, women can protect their heart health by making lifestyle changes and working with healthcare professionals to manage risk factors.

A family history of cardiovascular disease (CVD) can increase an individual's risk of developing CVD. If a close family member, such as a parent or sibling, has had CVD, an individual may be more likely to develop the disease themselves. However, having a family history of CVD does not necessarily mean that an individual will develop the disease, and there are many steps that can be taken to reduce the risk of CVD, such as making lifestyle changes and working with healthcare professionals to manage risk factors.

Smoking is a major risk factor for cardiovascular disease (CVD). The chemicals in tobacco smoke can damage the lining of blood vessels, leading to a buildup of plaque and narrowing of the arteries, which can increase the risk of heart attack and stroke. In addition, smoking can contribute to other risk factors for CVD, such as high blood pressure and high cholesterol. Quitting smoking is one of the most effective ways to reduce the risk of CVD, and there are many resources available to help individuals quit, including medications, counseling, and support groups.

Diabetes is a significant risk factor for cardiovascular disease (CVD). High blood sugar levels can damage blood vessels and increase the risk of atherosclerosis, a buildup of plaque in the arteries that can lead to heart attack and stroke. People with diabetes are also more likely to have other risk factors for CVD, such as high blood pressure and high cholesterol. Managing diabetes through lifestyle changes and medications can help reduce the risk of CVD and its complications.

Obesity is a major risk factor for cardiovascular disease (CVD). Excess body fat can lead to the development of other risk factors for CVD, such as high blood pressure, high cholesterol, and type 2 diabetes. Additionally, obesity can put extra strain on the heart and increase the risk of heart attack and stroke. Obesity is also strongly associated with sleep apnea, a condition in which breathing repeatedly stops and starts during sleep. Sleep apnea has been linked to an increased risk of CVD, and treating sleep apnea through weight loss, continuous positive airway pressure (CPAP), or other therapies may help reduce this risk. Losing weight through lifestyle changes, such as a healthy diet and regular physical activity, can also help reduce the risk of CVD and improve overall health.

High blood pressure, or hypertension, is a major risk factor for cardiovascular disease (CVD). When blood pressure is consistently high, it can damage the walls of blood vessels, making them more susceptible to the buildup of plaque and narrowing of the arteries that can lead to heart attack and stroke. High blood pressure also increases the workload on the heart, making it work harder than normal and increasing the risk of heart failure. Managing blood pressure through lifestyle changes and medications can help reduce the risk of CVD and its complications. It is important to regularly monitor blood pressure and work with a healthcare provider to keep it at a healthy level.

High levels of LDL cholesterol, as well as other lipids such as triglycerides and lipoprotein(a) [LP(a)], are significant risk factors for cardiovascular disease (CVD). These lipids can accumulate in the walls of arteries, leading to the formation of plaque that can narrow or block blood flow and increase the risk of heart attack and stroke. In many cases, lipid levels can be successfully managed through lifestyle changes, such as a heart-healthy diet and regular physical activity, as well as medications if needed. Managing lipid levels can help reduce the risk of CVD and its complications. It is important to regularly monitor lipid levels and work with a healthcare provider to keep them within a healthy range.

Physical inactivity is a significant risk factor for cardiovascular disease (CVD). Regular physical activity can help improve cardiovascular health by strengthening the heart and reducing other risk factors such as high blood pressure, obesity, and high cholesterol. In contrast, a sedentary lifestyle can increase the risk of CVD by contributing to these risk factors. Incorporating regular physical activity into your daily routine, such as walking, jogging, or cycling, can help reduce your risk of CVD and improve your overall health. It is important to talk to your healthcare provider before starting a new exercise program to ensure it is safe and appropriate for you.

Excessive alcohol consumption can contribute to high blood pressure, irregular heartbeat (e.g. atrial fibrillation), and can lead to a weakened heart muscle, which increases the risk of heart failure. Excessive drinking can also have negative effects on the liver and other organs, in addition to increasing the risk of other health problems. If you choose to drink alcohol, it is important to do so in moderation and talk to your healthcare provider about your alcohol consumption habits and any potential risks to your health.

Heart Health
Frequently asked Questions

We understand that seeking reliable information about your heart can be overwhelming, and that’s why we’ve compiled a list of common questions and their answers to empower you with knowledge. Whether you want to learn about normal heart rates, blood pressure, heart disease risk factors, or heart-healthy lifestyle choices, we’ve got you covered. You can find additional information in the Resources secton by clicking here.

The normal resting heart rate for adults typically ranges between 60 to 100 beats per minute (BPM). However, factors like age, fitness level, and overall health can influence this range. Consult your healthcare provider if you have concerns about your heart rate.

A normal blood pressure reading for adults is usually around 120/80 mmHg. The top number (systolic pressure) measures the pressure in your arteries when the heart beats, while the bottom number (diastolic pressure) indicates the pressure when the heart is at rest. Blood pressure can vary, so it’s essential to monitor it regularly

Several risk factors contribute to heart disease, including high blood pressure, high cholesterol levels, smoking, physical inactivity, obesity, diabetes, family history of heart disease, and age. Making lifestyle changes and managing these risk factors can significantly reduce your chances of developing heart disease

Improving heart health involves adopting a heart-healthy lifestyle. This includes engaging in regular physical activity, maintaining a balanced diet rich in fruits, vegetables, whole grains, and lean proteins, quitting smoking, managing stress, and getting enough sleep. Regular check-ups with your healthcare provider are also crucial to monitor your heart health.

Cholesterol is a waxy, fat-like substance present in our blood. It is essential for various bodily functions, but high levels of LDL (low-density lipoprotein) cholesterol, often referred to as “bad” cholesterol, can lead to plaque buildup in arteries, increasing the risk of heart disease. HDL (high-density lipoprotein) cholesterol, known as “good” cholesterol, helps remove LDL cholesterol from the bloodstream. Other important molecules include triglycerides and Lipoprotein (a). 

Common symptoms of a heart attack include chest pain or discomfort, pain or discomfort in the jaw, neck, back, or arms, shortness of breath, cold sweats, nausea, and lightheadedness. If you suspect you or someone else is having a heart attack, call emergency services immediately.

No, not all fats are bad for the heart. Healthy fats, such as monounsaturated and polyunsaturated fats found in nuts, seeds, avocados, and olive oil, can be beneficial for heart health. On the other hand, saturated and trans fats found in fried and processed foods should be limited as they can raise cholesterol levels and increase the risk of heart disease.

Yes, chronic stress can have a negative impact on heart health. Prolonged stress may lead to unhealthy coping mechanisms like overeating, smoking, or being physically inactive, which can increase the risk of heart disease. Managing stress through relaxation techniques, exercise, and seeking support can help promote heart health.

Warning signs of heart disease include chest pain or discomfort, shortness of breath, fatigue, palpitations, dizziness, and swelling in the ankles, feet, and legs. If you experience any of these symptoms, consult a healthcare professional promptly.

To naturally improve cholesterol levels, focus on a heart-healthy diet rich in soluble fiber from oats, beans, and vegetables. Added fiber can also be derived from simple sources such as psyllium husk. Iincorporating phytosterol-rich foods like fortified milks and spreads can assist and opting for healthy fats and oils found in olive oil, avocado and fatty fish, as they can boost good HDL cholesterol.  Stay physically active, maintain a healthy weight, and quit smoking to positively impact cholesterol levels. Limit added sugars and refined carbs, and moderate alcohol consumption.

The Lifeblood of Our Heart

The coronary arteries

The coronary arteries play a critical role in maintaining a healthy heart by supplying oxygen-rich blood to its muscles. However, when these arteries become diseased, it can have serious consequences.

The symptoms and complications of coronary artery disease (CAD) vary depending on the extent and location of the disease within the heart arteries.

The heart primarily has two main arteries, the left coronary artery and the right coronary artery. The left coronary artery further branches into the left anterior descending artery and the left circumflex artery, ensuring adequate blood flow to the entire heart. The specific artery affected determines the symptoms experienced, including chest pain, shortness of breath, fatigue, or asymptomatic cases.

Tailoring the best treatment strategy, whether through lifestyle changes, medications, stents, or bypass surgery, is crucial and based on a personalized assessment of the affected coronary artery/arteries. This emphasizes the importance of individualized care and management in addressing CAD.

Unmasking the Silent Intruder

plaque build-up

Coronary artery disease (CAD) is a widespread condition characterized by the narrowing or blockage of the coronary arteries, which supply oxygen-rich blood to the heart muscle. One of the primary culprits behind CAD is the gradual accumulation of lipid plaque within the arterial walls. In this section, we shed light on this process and its potential consequences, leading to restricted blood flow or even an acute myocardial infarction (AMI).

The initiation:

Coronary artery disease starts with artery damage caused by risks including smoking, high blood pressure, diabetes or high cholesterol.

Plaque development:

In response to injury, cholesterol and other substances infiltrate the damaged area, initiating formation of plaques that may cause narrowings.

Progressive accumulation:

Over time, the plaques accumulate layers of cholesterol, calcium, and cellular debris, causing the artery walls to thicken and narrow.

Restricted flow:

As the plaque enlarges, it restricts the flow of blood to the heart muscle, leading to symptoms such as chest pain (angina) or shortness of breath.

The tipping point:

In some cases, plaque can rupture, causing a clot to form. If this becomes large enough to completely block the artery, it can result in a heart attack.

Coronary Artery Disease

Common symptoms

Recognizing common symptoms of CAD, such as chest pain (angina), shortness of breath, and silent ischemia, is vital for early detection. Myocardial infarction (heart attack) is a severe complication. When in doubt or experiencing persistent symptoms, seeking advice from a healthcare professional is crucial. Early detection and management are key to improving outcomes and preventing complications.

Chest Pain - Angina

Angina can feel pressure, tightness, squeezing, or a burning sensation in the chest. It is typically triggered by physical exertion or emotional stress and tends to subside with rest.

Shortness of Breath

This may  occur during physical activity or even at rest. The reduced blood flow to the heart muscle due to narrowed arteries can lead to less oxygen supply, causing breathlessness.

Silent Ischemia

Some cases, particularly those with diabetes mellitus, may experience silent ischemia. This refers to a lack of typical symptoms despite reduced blood flow to the heart with minimal to no symptoms. 

Myocardial Infarction

Symptoms of a heart attack may include intense and prolonged chest pain, tightness or discomfort, shortness of breath, sweating, nausea, vomiting and pain radiating to the arms, jaw, or back. 

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Medicines Hub

Medications for managing
coronary artery disease

Let's delve into the diverse range of medications used in the management of coronary artery disease (CAD) and associated symptoms like angina. These medications play a crucial role in improving symptoms and preventing complications. Always discuss medicines with your doctor and pharmacist.

Medicines Hub

looking inside blockages

From the inside

Here we present a video demonstrating some innovative research using a technology called optical coherence tomography (OCT for short). This technology utilizes near infrared light to scan within the arteries of the heart and can visualize plaques in high resolution. Professor Barlis discusses the use of OCT to better understand how plaques develop and cause complications.


What are heart stents?

The specific characteristics of heart stents can vary depending on the manufacturer and the advancements in stent technology. It is essential for healthcare professionals to determine the most appropriate stent size, length, and type based on individual patient needs and the severity of the coronary artery disease. Here are some basic statistics:

Stents act to prop open narrowed arteries caused by plaque build-up in the wall of the heart arteries

Usually made of biocompatible metals, such as stainless steel or cobalt-chromium alloys

Heart stents typically range in length from 8 to 48 millimeters, depending on the specific needs of the patient and the location of the blockage within the coronary artery

Stent diameter can range from as small as 2.25 millimeters to as large as 5.0 millimeters

Future Developments

3D printed
heart stents

In recent years, 3D printing technology has emerged as a groundbreaking tool in the medical field, offering exciting possibilities for personalized healthcare solutions. One area where 3D printing holds immense promise is in the development of personalized heart stents.

Traditional heart stents come in predetermined sizes and designs, which may not always perfectly match the anatomical variations of each patient's coronary arteries. However, 3D printing enables the creation of custom-designed stents tailored to the unique specifications of an individual's arterial anatomy.

By utilizing advanced imaging techniques, such as computed tomography (CT) scans or optical coherence tomography (OCT), we can generate detailed 3D models of a patient's coronary arteries. These models serve as a blueprint for designing stents that precisely fit the patient's vessels, optimizing the stent's effectiveness and reducing the risk of complications.

Coronary artery disease Heart MattersCoronary artery disease Heart Matters

Dr Eric Poon, BEng, PhD

Chief Biomedical Engineer, Vascutech Pty Ltd.

and Honorary Researcher, Graeme Clark Institue

The University of Melbourne

1.3+ Million youtube views

All about heart stents

This informative and engaging video delves into the intricate details of heart stents, providing viewers with a comprehensive understanding of their significance in cardiovascular health. With its compelling visuals, expert narration, and accessible explanations, the video has successfully captured the attention of a wide audience, highlighting the ever-growing importance of heart health education in today’s digital age.

Surgical Revascularization
Coronary arery bypass grafting (CABG)

Bypass Surgery

Bypass surgery, also known as coronary artery bypass grafting (CABG), is a surgical procedure that may be recommended for certain cases of coronary artery disease (CAD). Particularly, it is considered when there is multivessel disease (narrowing or blockages in multiple coronary arteries) or involvement of the left main artery, which supplies a large portion of the heart muscle. Bypass surgery offers a potential solution by creating new pathways (grafts) using blood vessels from other parts of the body to bypass the blocked or narrowed coronary arteries, restoring improved blood flow to the heart.

Coronary Artery Disease

Useful Resources

Presenting a selection of articles on coronary artery disease (CAD) and its management. CAD is a common heart condition caused by narrowed or blocked coronary arteries, leading to complications like angina, heart attack, and heart failure. The articles cover risk factors, diagnostics, treatments, prevention, and research advancements.

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other anti-anginals

When first-line therapies for angina, such as beta blockers, calcium channel blockers, and nitrates, prove inadequate or are not well-tolerated, second-line therapies may be considered.
Perhexiline is a unique medication that enhances the heart's ability to utilize fatty acids for energy, reducing its reliance on oxygen and lowering oxygen demand. This action helps improve blood flow and alleviates chest pain in some patients with refractory angina.
Nicorandil is another second-line option with a dual mechanism of action. It opens potassium channels in smooth muscle cells, causing vasodilation and enhancing coronary blood flow. Additionally, nicorandil also stimulates nitric oxide release, further dilating blood vessels and reducing heart workload.
Trimetazidine is an anti-ischemic agent that improves cardiac efficiency by enhancing glucose metabolism and shifting the heart's energy production to a more oxygen-efficient process. As second-line therapies, these medications offer alternative approaches for managing angina in individuals who do not respond adequately to first-line treatments or those experiencing side effects from other medications.

lipid lowering therapies

Lipid-lowering therapies play a critical role in managing coronary artery disease (CAD), a condition characterized by the narrowing of blood vessels that supply the heart. Among the most commonly discussed and debated classes of medications are statins, which effectively reduce cholesterol levels and are widely prescribed to lower the risk of cardiovascular events. Alongside statins, other medications like ezetimibe, fibrates, and niacin are also utilized to target specific aspects of lipid metabolism, such as cholesterol absorption, triglyceride levels, and raising high-density lipoprotein (HDL) cholesterol. Additionally, the introduction of medications that inhibit PCSK9, an enzyme involved in cholesterol metabolism, has provided a promising new approach to further lower LDL cholesterol levels. These PCSK9 inhibitors, such as Repatha (evolocumab), have shown significant efficacy in reducing LDL cholesterol levels in patients with CAD, especially for those who may not respond well to traditional therapies.


Nitrates are widely used to treat angina and provide quick relief for chest pain. Commonly available in the form of sublingual sprays or tablets, patches, and long-acting tablets, nitrates work by dilating blood vessels, allowing for increased blood flow and reduced resistance. This dilation eases the heart's workload, leading to a decreased demand for oxygen and prompt alleviation of angina symptoms. Sublingual nitrates act rapidly and are often used to provide immediate relief during angina attacks, while patches and long-acting tablets are employed for preventive purposes. However, nitrates may cause side effects such as headaches, dizziness, and flushing, which usually subside over time.

calcium channel blockers

Calcium channel blockers, including amlodipine, felodipine, cardizem (diltiazem), and verapamil, are commonly prescribed for the treatment of angina. These medications work by inhibiting the influx of calcium into the muscle cells of the heart and blood vessels, leading to their relaxation. As a result, blood vessels widen, promoting improved blood flow and reduced blood pressure. In the context of angina, this relaxation decreases the heart's workload, lowering the demand for oxygen and alleviating chest pain. Calcium channel blockers offer a valuable treatment option for individuals with angina, but it is essential to be aware of potential side effects, which may include headaches, dizziness, flushing, and ankle swelling.

Beta blockers

Beta blockers, such as metoprolol, propranolol, atenolol, carvedilol, and bisoprolol, play a crucial role in treating angina. By blocking certain receptors in the heart, they effectively reduce heart rate and the force of contraction, thereby easing the heart's workload. This mechanism of action leads to a decreased demand for oxygen, making beta blockers highly effective in relieving chest pain associated with angina. As with any medication, it's important to consider potential side effects, including tiredness, worsened asthma, erectile dysfunction in some males, and more vivid dreams during sleep. Consult your healthcare provider to determine the suitability of beta blockers for managing your angina and overall heart health.

Anti-platelet Medications

Anti-platelet medications play a crucial role in preventing blood clot formation, reducing the risk of serious cardiovascular events such as heart attacks and strokes. Among the widely used anti-platelet drugs are aspirin, clopidogrel, and ticagrelor.

Aspirin: This well-known medication inhibits platelet activation, making it less likely for platelets to stick together and form clots. Aspirin is commonly used for primary and secondary prevention of heart attacks and strokes.

Clopidogrel: As a potent anti-platelet agent, clopidogrel works by blocking specific receptors on platelets, preventing them from aggregating. It is often prescribed to patients with acute coronary syndrome, those undergoing stent procedures, and for some cases of peripheral arterial disease.

Ticagrelor: Ticagrelor is another effective anti-platelet drug that works by inhibiting platelet activation. It is used in acute coronary syndrome, often given alongside aspirin to reduce the risk of heart-related events.