Coronary Artery Disease (CAD)
What is Coronary Artery Disease (CAD)?
Coronary artery disease happens when the arteries that supply blood to your heart become narrow or blocked. These arteries are called coronary arteries. They deliver oxygen and nutrients your heart muscle needs to pump blood throughout your body.
Over time, cholesterol and other substances build up on artery walls. This buildup is called plaque. As plaque accumulates, it narrows the arteries and reduces blood flow to your heart. When your heart does not get enough oxygen-rich blood, you may feel chest pain or shortness of breath. If a plaque ruptures completely and blocks an artery, it can cause a heart attack.
CAD is the most common type of heart disease in the United States. It develops slowly over decades. Many people have no symptoms until the blockage becomes severe. Early detection through blood testing can identify your risk years before symptoms appear. This gives you time to make changes that protect your heart.
Symptoms
- Chest pain or pressure, especially during physical activity or stress
- Shortness of breath during exertion or at rest
- Pain or discomfort in the arms, shoulders, neck, jaw, or back
- Fatigue or weakness, especially with activity
- Heart palpitations or irregular heartbeat
- Dizziness or lightheadedness
- Nausea or indigestion
- Sweating without obvious cause
Many people with early coronary artery disease have no symptoms at all. The disease can progress silently for years. Some people first learn they have CAD when they experience a heart attack. This is why screening with blood tests is so valuable for prevention.
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Causes and risk factors
CAD begins when the inner walls of coronary arteries become damaged. High cholesterol, high blood pressure, and smoking are the main causes of this damage. When the artery wall is injured, cholesterol particles and inflammatory cells accumulate at the site. This creates plaque that hardens and narrows the artery over time. High levels of LDL cholesterol and apolipoprotein B drive this process. Low levels of HDL cholesterol reduce your body's ability to remove harmful cholesterol from artery walls.
Risk factors include age over 45 for men and over 55 for women, family history of early heart disease, diabetes, obesity, physical inactivity, chronic stress, and poor diet. Elevated lipoprotein(a) is a genetic risk factor that increases plaque formation. Omega-3 fatty acid deficiency may contribute to inflammation and plaque instability. Insulin resistance and metabolic syndrome accelerate artery damage. Many of these risk factors can be modified through lifestyle changes and targeted treatment.
How it's diagnosed
CAD is diagnosed using a combination of medical history, physical exam, and testing. Your doctor will ask about symptoms, risk factors, and family history. Blood tests are the first step in assessing your risk. Advanced lipid panels measure cholesterol, LDL particle number, LDL particle size, apolipoprotein levels, and lipoprotein(a). These biomarkers reveal your risk even before symptoms appear. Rite Aid offers comprehensive testing that includes over 200 biomarkers to evaluate your cardiovascular health.
If blood tests show elevated risk or if you have symptoms, your doctor may order additional tests. These can include an electrocardiogram to check heart rhythm, a stress test to see how your heart performs during exercise, or imaging tests like CT angiography or cardiac catheterization. These procedures visualize the coronary arteries and measure the extent of blockage. Regular blood testing helps monitor disease progression and track how well treatments are working.
Treatment options
- Eat a heart-healthy diet rich in vegetables, fruits, whole grains, lean protein, and omega-3 fatty acids from fish
- Exercise for at least 150 minutes per week with a mix of aerobic and strength training activities
- Quit smoking and avoid secondhand smoke exposure
- Maintain a healthy weight through balanced nutrition and regular physical activity
- Manage stress through mindfulness, meditation, adequate sleep, and social connection
- Limit alcohol intake to no more than 1 drink per day for women and 2 for men
- Take statins to lower LDL cholesterol and reduce plaque buildup
- Use blood pressure medications if lifestyle changes are not enough to control hypertension
- Take aspirin or other antiplatelet drugs to prevent blood clots
- Consider PCSK9 inhibitors or other advanced lipid-lowering medications for high-risk patients
- Work with a cardiologist for severe blockages that may require procedures like angioplasty or bypass surgery
Concerned about Coronary Artery Disease (CAD)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
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Frequently asked questions
Coronary artery disease is the gradual narrowing of arteries that supply blood to your heart. A heart attack happens when a coronary artery becomes completely blocked, usually by a ruptured plaque. CAD is the underlying condition that increases your risk of having a heart attack. Many people with CAD never have a heart attack if they manage their risk factors effectively.
While existing plaque cannot be completely removed, aggressive lifestyle changes and medication can stabilize plaque and prevent progression. Some studies show that very low LDL cholesterol levels combined with plant-based diets can slightly reduce plaque size. The goal is to stop the disease from advancing and reduce your risk of heart attack. Early intervention gives you the best chance to protect your heart.
Adults with risk factors should have comprehensive lipid testing at least once per year. If you are on medication or making lifestyle changes, testing every 3 to 6 months helps you and your doctor see how well treatments are working. Advanced testing that includes LDL particle number and apolipoprotein levels provides more detailed risk assessment than basic cholesterol panels.
LDL particle number counts how many LDL cholesterol particles are in your blood. You can have normal LDL cholesterol levels but still have too many particles. More particles mean greater risk because each one can penetrate artery walls and form plaque. LDL particle number is a stronger predictor of heart disease risk than standard LDL cholesterol measurements.
No, chest pain has many possible causes including muscle strain, heartburn, anxiety, and lung conditions. CAD-related chest pain typically feels like pressure or squeezing and often occurs with physical exertion or emotional stress. It usually improves with rest. However, some people with significant CAD have no chest pain at all, especially women and people with diabetes.
Foods rich in fiber, omega-3 fatty acids, and antioxidants support heart health. Focus on vegetables, fruits, whole grains, beans, nuts, seeds, and fatty fish like salmon. Olive oil, avocados, and other sources of healthy fats improve cholesterol levels. Limit saturated fats from red meat and full-fat dairy, avoid trans fats completely, and reduce added sugars and refined carbohydrates.
Chronic stress contributes to CAD by raising blood pressure, increasing inflammation, and promoting unhealthy behaviors like poor diet and lack of exercise. Stress hormones can damage artery walls and make existing plaque more likely to rupture. Managing stress through regular physical activity, adequate sleep, social support, and relaxation techniques is an important part of heart disease prevention.
Lipoprotein(a) is a type of cholesterol particle that promotes plaque formation and blood clots. Your level is mostly determined by genetics and does not respond much to diet or standard cholesterol medications. Elevated lipoprotein(a) significantly increases CAD risk. If your level is high, you may need more aggressive treatment of other risk factors and specialized medications.
High blood sugar damages blood vessel walls and accelerates plaque buildup. Diabetes often occurs alongside other risk factors like high blood pressure, abnormal cholesterol, and obesity. People with diabetes are 2 to 4 times more likely to develop CAD. Controlling blood sugar, maintaining healthy cholesterol and blood pressure, and following a heart-healthy diet are essential for prevention.
Most adults should begin cholesterol screening by age 20 and repeat it every 4 to 6 years if results are normal. Earlier and more frequent testing is recommended if you have risk factors like family history, high blood pressure, diabetes, or obesity. Men over 45 and women over 55 have higher baseline risk and benefit from annual comprehensive testing with advanced biomarkers.