Coronary heart disease develops when the arteries that supply blood to the heart muscle become narrowed or blocked by plaque. The heart itself is starved of oxygen, and the consequences range from chest pain to heart attack.

Atherosclerosis is the usual culprit. Fatty deposits build up on the inner walls of the coronary arteries, reducing blood flow. Risk factors include high blood pressure, elevated cholesterol, smoking, diabetes, obesity, physical inactivity, and a family history of the disease. Stress and certain personality patterns have also been linked to higher incidence. Men tend to develop it earlier than women, though the gap narrows after menopause.

Symptoms can be subtle at first—shortness of breath, fatigue, or discomfort that comes with exertion. A complete blockage produces a myocardial infarction, in which part of the heart muscle dies. Diagnosis relies on stress tests, angiograms, and imaging of the coronary vessels. Treatment ranges from lifestyle changes and medication to angioplasty, stenting, or bypass surgery.

Prevention remains the strongest strategy. Managing blood pressure, cholesterol, and weight, and staying active, can slow or even reverse the process that leads to coronary heart disease.