Causes Of Coronary Heart Disease

Causes Of Coronary Heart Disease

There are three main types of coronary heart disease: obstructive coronary artery disease, nonobstructive coronary artery disease, and coronary microvascular disease. Coronary artery disease affects the large arteries on the surface of the heart. Many people have both obstructive and nonobstructive forms of this disease. The coronary microvascular disease affects the tiny arteries in the heart muscle.

The cause depends on the type of coronary heart disease. The condition may also have more than one cause, including plaque buildup or problems that affect how the heart’s blood vessels work. Visit How the Heart Works to learn more.

Plaque buildup

- Coronary Heart Disease - Causes

plaque buildup in the arteries is called atherosclerosis. When this buildup happens in the heart's arteries over many years, the arteries become narrower and harden, reducing oxygen-rich blood flow to the heart. The result is coronary artery disease.

Obstructive coronary artery disease means the heart’s arteries are more than 50% blocked. The blood flow may eventually be completely blocked in one or more of the three large coronary arteries. In nonobstructive coronary artery disease, the large arteries may be narrowed by plaque, but not as much as they are in obstructive disease.

Small plaques can also develop in the small blood vessels in the heart, causing coronary microvascular disease.

Problems affecting the blood vessels

- Coronary Heart Disease - Causes

Problems with how the heart’s blood vessels work can cause coronary heart disease. For example, the blood vessels may not respond to signals that the heart needs more oxygen-rich blood. Normally, the blood vessels widen to allow more blood flow when a person is physically active or under stress. But if you have coronary heart disease, the size of these blood vessels may not change, or the blood vessels may even narrow.

The cause of these problems is not fully clear. But it may involve:

  • Damage or injury to the walls of the arteries or tiny blood vessels from chronic inflammation, high blood pressure, or diabetes.
  • Molecular changes that are part of the normal aging process. Molecular changes affect the way genes and proteins are controlled inside cells.

In nonobstructive coronary artery disease, damage to the inner walls of the coronary arteries can cause them to spasm (suddenly tighten). This is called vasospasm. The spasm causes the arteries to narrow temporarily and blocks blood flow to the heart.

Source Agency: National Heart, Lung, and Blood Institute (NHLBI)

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