Coronary heart disease - Causes 

Causes of heart disease 

CHD Dave's story: high cholesterol

Having high cholesterol can put you at greater risk of heart disease. Dave shares his battle with his cholesterol levels, and talks about how he got to where he is now, successfully managing his condition.

Media last reviewed: 11/11/2013

Next review due: 11/11/2015

Apples and pears

Your body shape may increase your risk of CHD. The incidence of heart disease and diabetes is higher in people who are "apple-shaped" (who store fat around their abdomens) than in those who are "pear-shaped" (people with fat mostly around the hips and thighs).

Read about why body shape matters.

Know your blood pressure

The normal range for blood pressure readings is 120/80 to 140/90, although many healthy people have a lower blood pressure than 120/80.

If yours is consistently high, you have a greater risk of developing coronary heart disease and having a stroke.

Ask your GP to check your blood pressure.

Coronary heart disease (CHD) is usually caused by a build-up of fatty deposits on the walls of the arteries around the heart (coronary arteries).

The fatty deposits, called atheroma, are made up of cholesterol and other waste substances.

The build-up of atheroma on the walls of the coronary arteries makes the arteries narrower and restricts the flow of blood to the heart. This process is called atherosclerosis. Your risk of developing atherosclerosis is significantly increased if you:

Other risk factors for developing atherosclerosis include:

  • being obese or overweight
  • having a family history of CHD – the risk is increased if you have a male relative with CHD under 55 or a female relative under 65


Cholesterol is a fat made by the liver from the saturated fat that we eat. Cholesterol is essential for healthy cells, but if there is too much in the blood it can lead to CHD.

Cholesterol is carried in the blood stream by molecules called lipoproteins. There are several different types of lipoproteins, but two of the main ones are low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

LDL, often referred to as bad cholesterol, takes cholesterol from the liver and delivers it to cells. LDL cholesterol tends to build up on the walls of the coronary arteries, increasing your risk of heart disease.

HDL, often referred to as "good cholesterol", carries cholesterol away from the cells and back to the liver, where it is broken down or passed from the body as a waste product.

In the UK, the current government recommendation is that you should have a total blood cholesterol level of less than 5mmol/litre, and an LDL cholesterol level of under 3mmol/litre. This should be even lower if you have symptoms of CHD.

Want to know more?

High blood pressure

High blood pressure (hypertension) puts a strain on your heart and can lead to CHD.

Blood pressure is measured at two points during the blood circulation cycle. The systolic pressure is a measure of your blood pressure as the heart contracts and pumps blood out. The diastolic pressure is a measure of your blood pressure when your heart is relaxed and filling up with blood.

Blood pressure is measured in terms of millimetres of mercury (mmHg). When you have your blood pressure measured, the systolic pressure is the first, higher number to be recorded. The diastolic pressure is the second, lower number to be recorded. High blood pressure is defined as a systolic pressure of 140mmHg or more, or a diastolic pressure of 90mmHg or more.

Want to know more?


Smoking is a major risk factor. Carbon monoxide (from the smoke) and nicotine both put a strain on the heart by making it work faster. They also increase your risk of blood clots.

Other chemicals in cigarette smoke damage the lining of your coronary arteries, leading to furring of the arteries. If you smoke, you increase your risk of developing heart disease by 24%.


While a high blood sugar level doesn't directly increase the risk of developing CHD, it may lead to diabetes, which can more than double your risk of developing CHD.

Diabetes can lead to CHD because it may cause the lining of blood vessels to become thicker, which can restrict blood flow.

Read more about diabetes.


thrombosis is a blood clot within an artery (or a vein). If a thrombosis occurs in a coronary artery (coronary thrombosis), it will cause the artery to narrow, preventing the blood supply from reaching the heart muscle. This increases your chance of having a heart attack. Coronary thrombosis usually happens at the same place that the atherosclerosis is forming (furring of the coronary arteries).

Page last reviewed: 10/09/2012

Next review due: 10/09/2014


How helpful is this page?

Average rating

Based on 264 ratings

All ratings

Add your rating


The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

User742371 said on 22 January 2013

Heart Strokes in Youth increased for more information

The percentage of heart strokes in the people are increasing day-by-day especially in the young people because of their food habits. In 1993, the heart strokes were 13% among the people aged below 55 and now the percentage increased to 18%in...

Report this content as offensive or unsuitable

User363614 said on 09 November 2011

Heart disease is not correlated with cholesterol levels, it is however correlated with elevated blood sugar. Lowering the glycaemic levels of your diet may beneficial, whereas lowering the saturated fat/cholesterol is unlikely to be, and can even be dangerous.

Report this content as offensive or unsuitable

thiruvelan said on 26 January 2010

Coronary heart disease (CHD) risk factor is high if smoke, high blood pressure, have a high blood, high cholesterol level, and have diabetes.

Coronary artery disease (CAD) or coronary heart disease is a condition in which plaque builds up inside the coronary arteries, which supplies oxygen rich blood to the heart muscles.

Report this content as offensive or unsuitable

TKes said on 26 November 2009

One of the ways recommended to reduce the risk of a heart attack is to lower your blood cholesterol. But the question is: By how much?

As understand it, a cholesterol of less than 5 is reckoned to be the healthiest. But that doesn't jibe with a lot of evidence that suggests that 5 or less is actually too low for someone who is middle aged or older.

A UK cholesterol and health website, lists a whole bunch of conditions under "the dangers of low cholesterol", which are probably worse than having a heart attack as they cover things like Alzheimers' up to an earlier death, in people with cholesterol levels that are too low. And, by too low, it seems to be talking about levels less than about 6.8

As I am approaching my 50th, I think I'll leave my 6.2 as it is - at least for now.

Report this content as offensive or unsuitable

Healthy weight calculator

Check your BMI

Use our healthy weight calculator to easily measure your or your child’s BMI (body mass index)

Diabetes self-assessment

Type 2 diabetes check

Take this quick and simple test to find out if you are at risk of type 2 diabetes