Coronary heart disease
Coronary heart disease (CHD) is the leading cause of death in the UK. It occurs when the coronary arteries, which supply blood to the heart muscle, become narrowed or blocked by a build-up of fatty deposits (atherosclerosis).
CHD develops over many years and may not cause symptoms until the arteries are significantly narrowed. Symptoms can include angina (chest pain on exertion), shortness of breath and, in the most serious cases, a heart attack.
Risk factors include high cholesterol, high blood pressure, smoking, diabetes, obesity, physical inactivity and a family history of heart disease.
Beyond standard lipid tests, markers such as high-sensitivity CRP (hs-CRP) measure low-grade vascular inflammation, and lipoprotein(a) identifies a genetic risk factor that standard cholesterol tests do not capture. The PLAC test (Lp-PLA2) assesses arterial inflammation associated with unstable plaque, offering additional cardiovascular risk information.
Causes of Coronary heart disease
Coronary heart disease is caused by atherosclerosis, the gradual build-up of fatty deposits (plaques) within the walls of the coronary arteries. This process begins with damage to the inner lining of the artery and progresses over decades.
The major modifiable risk factors are:
- Smoking, which damages artery walls and accelerates plaque formation
- High blood pressure, which increases the force on artery walls
- High cholesterol, particularly elevated LDL cholesterol and lipoprotein(a)
- Type 2 diabetes, which damages blood vessels through chronic glucose elevation
- Obesity and physical inactivity
- Unhealthy diet high in saturated fat, salt and refined sugars
Non-modifiable risk factors include age, male sex, family history of early heart disease and ethnicity. South Asian populations have a higher incidence of CHD compared to the general UK population.
Tests that can help check this condition
Learn more on the official NHS page .
