Coronary Artery Disease: How to Reduce Your Risk

Coronary artery disease is a common heart condition in the United States and is a leading cause of death for both men and women.

Dmitry Familtsev, MD, PhD, a general cardiologist with the Phelps Health Heart and Vascular Center, answers some common questions about coronary artery disease, its symptoms and what preventive measures you can take to help protect yourself or your loved ones.

What is coronary artery disease?

Coronary artery disease is an atherosclerotic disease (or damage or disease in the heart’s major blood vessels). The arteries of the heart collect atherosclerotic (or lipid-rich) plaque, which is related to cholesterol, and sometimes can be calcified.

Coronary artery disease can be acute (severe or sudden), [such as] a heart attack, stroke or certain cardiac death [resulting from a heart attack]. [The other type of] coronary artery disease [is] when people have a stable [increase of] plaque that obstructs the flow in the arteries of the heart to the point that the patient starts experiencing symptoms, such as chest pains, shortness of breath with exertion or overwhelming fatigue.

How common is coronary artery disease?

Coronary artery disease is very common. Genetics plays a strong role in coronary artery disease and is one of the strongest risk factors. If you have somebody with coronary artery disease, especially your immediate family member, which is mom, dad or siblings, your chance of having coronary artery disease is much higher than otherwise.

[For] women, [their] incidence of coronary artery disease is lower than in men. A lot of that has to do with estrogen production. However, after menopause, women lose their protection from estrogen, and [are in the] same risk category as men. If you compare men and women around 70 years old, their risk of coronary artery disease is probably going to be the same.

What preventive measures can you take to help reduce your risk of coronary artery disease?

The first and foremost thing is lifestyle modifications. Everything that goes into primary prevention [making lifestyle changes before a health event occurs] is still applicable to a secondary prevention [making lifestyle changes to prevent a health event from happening again or worsening], [such as] improving diet, reducing salt intake, monitoring blood pressure, losing weight, quitting smoking and exercising regularly.

What diet is best to help with heart health?

The only proven diet for coronary artery disease [to improve] your morbidity and mortality is a Mediterranean diet. The Mediterranean diet has been proven over and over, [and] it includes vegetables, certain fruits [that are] not high in sugars and fructose, [and unsalted] nuts, because salt is a problem for cardiovascular disease.

Fish should be [a] predominant food. [You should] eat fish at least twice a week, and one of those dishes should be an oily type of fish. Red meat [should be kept] to a minimum, and [you] should include some unsaturated oils, [such as] olive oil.

Trans fats and processed foods should be either completely excluded or reduced to minimum. I always tell my patients, you have to live; you have to enjoy life and [the] taste of things, but you [should only do this] once in a [while].