Risk Factors for Coronary Heart Disease

Updated on September 20, 2019
Michelle Tram profile image

Michelle hopes to spread awareness of various health topics by presenting relevant medical findings in her short articles.

“Each year, about 370,000 Americans die from coronary heart disease.”

— National Heart, Lung, and Blood Institute

What is Coronary Heart Disease?

Patients diagnosed with coronary heart disease (CHD) fail to maintain an adequate supply of oxygen to heart muscle cells due to atherosclerosis in the coronary artery. Atherosclerosis involves the buildup of plaque, which is composed of cholesterol, calcium, and other fatty substances. Over time, the hardening of plaque narrows the blood vessel, making it increasingly difficult to deliver blood cells. Further, plaque deposits can rupture, stimulating the formation of blood clots that can then block the artery. During physical activity, patients often experience angina pectoris, described as discomfort or pressure in the chest, shoulders, arms, and surrounding areas of the body. In severe cases, coronary heart disease can cause myocardial infarctions, or heart attacks.

The buildup of plaque in the coronary artery
The buildup of plaque in the coronary artery | Source

Common Risk Factors for CHD

High Consumption of Red Meat

Beyond the high fat content in red meat, scientists have identified an additional harm: the chemical production of trimethylamine N-oxide (TMAO) by gut bacteria. A byproduct in the digestion of red meat, TMAO increases cholesterol accumulation in arteries and stimulates platelets. Researchers at the Cleveland Clinic recently performed a study confirming the positive correlation between red meat consumption and TMAO levels. The study rotated 113 healthy subjects on three distinct diets (red meat, white meat, and non-meat), each for a month in a randomized order. Half of the subjects were given high-fat versions of the three diets, each of the same number of calories.

In the red meat diet, each subject consumed 8 ounces of steak per day, which amounted to about two quarter-pound beef patties.

Upon analyzing results after each diet, the researchers concluded that the TMAO levels after a month of consuming the red meat diet were three times greater than during white meat or non-meat diets (“Study Links Frequent Red Meat Consumption to High Levels of Chemical Associated With Heart Disease”, 2018). Furthermore, the same trend was seen in the group participating in the high-fat diets, affirming that the increased TMAO levels were independent of fat intake and, rather, dependent on the protein source. In addition, results concluded that abstaining from red meat can help lower the amount of TMAO in one’s blood, providing a hopeful remedy for those with high TMAO levels.

A Short Video Explaining TMAO

High Cholesterol

Cholesterol is a lipid, or fat, required for basic biological functions, such as the construction of cell membranes, and transported within the body in lipoproteins. High-density lipoprotein (HDL) helps carry cholesterol from the cells to the liver, where it is then prepared for excretion as waste; thus, it is healthy to have high HDL. The second lipoprotein is low-density lipoprotein (LDL), responsible for providing cells with cholesterol for usage; however, a high amount of LDL can cause cholesterol deposits in artery walls, contributing to plaque buildup (“High Cholesterol”, 2018).

The effect of cholesterol buildup in the artery on blood flow
The effect of cholesterol buildup in the artery on blood flow | Source

High Blood Pressure

Blood pressure is measured by the pressures, or forces exerted, in blood vessels as the heart beats and during pauses between beats, specifically the systolic blood pressure and diastolic blood pressure, respectively. High blood pressure can cause damage to the inner walls of the inflexible arteries, resulting in small tears where LDL cholesterol can build up (“What is High Blood Pressure?”, 2016).


When smoking, the incomplete combustion of the cigarette produces carbon monoxide, which, when inhaled, combines with hemoglobin in the blood, resulting in a decrease of oxygen in the blood (“Smoking”). In addition, tobacco smoke consists of free radicals, or highly reactive atoms with unpaired electrons. These free radicals, containing oxygen and thus known as reactive oxygen species, oxidize LDL cholesterol in blood vessels, causing the oxidized LDL to become reactive with its environment (Yugar-Toledo et al., 2018). The resulting inflammation of vascular walls leads to the increased production of the pro-inflammatory and procoagulant cytokine interleukin 6 (IL-6) and consequently thrombosis, or blood clot formation in blood vessels that blocks blood flow (Tapson, 2005).



Diabetes is a disease where the body is unable to utilize or produce insulin, a hormone that assists cell absorption of glucose, thus contributing to high glucose levels in the blood. Patients with diabetes lack the enzyme extracellular signal-related kinase 5 (ERK-5) because of the body’s increased production of advanced glycation end products (AGEs), proteins or lipids that form covalent bonds with sugars. These AGEs interfere with the functioning of ERK-5 by encouraging its attachment to a protein tag in cells, specifically to small ubiquitin-related modifiers (SUMO). Without ERK-5, diabetic patients experience restricted blood vessels that can contribute to high blood pressure and consequently coronary heart disease. However, scientists believe that by removing the SUMO tag, they can combat the effects of AGEs and allow ERK-5 signalling for the creation of more nitric oxide to help dilate blood vessels (“How Diabetes Drives Atherosclerosis”, 2008).


These risk factors compose a non-exhaustive list of contributors to coronary heart disease. Additional elements include age, gender, race, and family history; however, these characteristics cannot be controlled, and thus it becomes especially crucial to manage a healthy lifestyle to prevent the advent of coronary heart disease.


“High Cholesterol.” NHS Choices, NHS, 30 July 2018, www.nhs.uk/conditions/high-cholesterol/.

“How Diabetes Drives Atherosclerosis.” ScienceDaily, University of Rochester Medical Center, 17 Mar. 2008, www.sciencedaily.com/releases/2008/03/080313124430.htm.

“Smoking.” British Heart Foundation, British Heart Foundation, www.bhf.org.uk/informationsupport/risk-factors/smoking.

“Study Links Frequent Red Meat Consumption to High Levels of Chemical Associated with Heart Disease.” National Heart Lung and Blood Institute, U.S. Department of Health and Human Services, 10 Dec. 2018, www.nhlbi.nih.gov/news/2018/study-links-frequent-red-meat-consumption-high-levels-chemical-associated-heart-disease.

Tapson, V. F. "The Role of Smoking in Coagulation and Thromboembolism in Chronic Obstructive Pulmonary Disease." Proc Am Thorac Soc 2.1 (2005): 71-7. Print.

“What Is High Blood Pressure?” American Heart Association, American Heart Association, 31 Oct. 2016, www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-high-blood-pressure.

Yugar-Toledo, Juan Carlos, et al. “Chapter 36 Smoking and the Endothelium.” Endothelium and Cardiovascular Diseases, Elsevier, 2018.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

    © 2018 Michelle Tram


      0 of 8192 characters used
      Post Comment

      No comments yet.


      This website uses cookies

      As a user in the EEA, your approval is needed on a few things. To provide a better website experience, youmemindbody.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

      For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://maven.io/company/pages/privacy

      Show Details
      HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
      LoginThis is necessary to sign in to the HubPages Service.
      Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
      AkismetThis is used to detect comment spam. (Privacy Policy)
      HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
      HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
      Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
      CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
      Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
      Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
      Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
      Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
      Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
      Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
      VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
      PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
      Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
      MavenThis supports the Maven widget and search functionality. (Privacy Policy)
      Google AdSenseThis is an ad network. (Privacy Policy)
      Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
      Index ExchangeThis is an ad network. (Privacy Policy)
      SovrnThis is an ad network. (Privacy Policy)
      Facebook AdsThis is an ad network. (Privacy Policy)
      Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
      AppNexusThis is an ad network. (Privacy Policy)
      OpenxThis is an ad network. (Privacy Policy)
      Rubicon ProjectThis is an ad network. (Privacy Policy)
      TripleLiftThis is an ad network. (Privacy Policy)
      Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
      Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
      Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
      Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
      ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
      Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)
      ClickscoThis is a data management platform studying reader behavior (Privacy Policy)