What is Coronary Artery Disease?
Navigating heart health terminology can feel overwhelming, but understanding these key terms helps you take control of your care:
- CVD (Cardiovascular Disease): The broad umbrella term for all diseases affecting the heart or blood vessels, including stroke, heart failure, and peripheral artery disease.
- CAD (Coronary Artery Disease): A specific, common type of CVD where plaque builds up in the arteries supplying the heart muscle.
- IHD (Ischemic Heart Disease): The clinical term for the condition caused by CAD, where the heart muscle receives insufficient blood flow and oxygen.
Essentially, CAD is the cause, IHD is the resulting condition, and CVD is the overall category that includes them both.
CAD: The Leading Cause of Death
Cardiovascular diseases (CVDs) are still the leading cause of death worldwide, and the numbers continue to rise. In 2023, nearly 20 million people died from CVDs. Coronary artery disease (CAD) is the most common form, responsible for about 9 million deaths every year. In fact, CAD causes more deaths each year than all types of cancer combined.
Causes and Risk Factors of CAD
Coronary artery disease gets worse as people age. It is affected by both changeable and unchangeable risk factors for men and women.
Changeable risk factors: | Unchangeable risk factors: |
|---|---|
• High blood pressure • Elevated low-density lipoprotein (LDL) cholesterol • Diabetes mellitus • Smoking • Obesity • Physical inactivity • Unhealthy diet | • Age • Sex (higher prevalence in men) • Family history of early CAD |
Coronary Artery Disease in Younger Women
While coronary artery disease (CAD) is often perceived as a condition affecting older men, recent research highlights an important trend: CAD is rising among younger women.
Why it matters
CAD in young women may sometimes follow cyclical patterns, influenced by hormonal changes across the menstrual cycle. In addition, ovarian hormones and vascular reactivity appear to play a role in how ischemia develops and presents clinically in this group.
Although traditional CAD risk factors, hypertension, diabetes, dyslipidaemia, obesity, and smoking, are shared between men and women, research shows that they can affect women differently. For example:
- Blood pressure rises earlier in life in women (as early as age 30–40) and tends to increase more rapidly than in men¹³.
- Women more frequently develop left ventricular hypertrophy and heart failure with preserved ejection fraction (HFpEF) as a consequence of long-standing hypertension¹³.
Adherence to antihypertensive treatment can be lower in younger women, amplifying risk over time. Hormonal and reproductive factors, including pregnancy complications and menopause, can influence vascular health across the lifespan¹³.
The importance of early detection
These findings emphasize the need for proactive cardiovascular risk assessment and prevention in younger women, especially those with multiple CAD-associated risk factors. Early identification of mechanical or functional cardiac changes, before symptoms become severe, can make a significant difference in long-term outcomes.
Rethinking Conventional CAD Testing
Identifying coronary artery disease earlier and with greater precision helps protect your heart and prevent long-term damage.
References
- American Heart Association. Coronary artery disease. Dallas (TX): American Heart Association; [cited 2025 Aug 14]. Available from: https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/coronary-artery-disease
- Cleveland Clinic. Silent heart attack: symptoms & treatment [Internet]. Cleveland (OH): Cleveland Clinic; c2022 [cited 2025 Jun 5]. Available from: https://my.clevelandclinic.org/health/diseases/21630-silent-heart-attack
- AAPC. ICD-10-CM code I25.1 – Atherosclerotic heart disease of native coronary artery [Internet]. Salt Lake City: AAPC; [cited 2025 Jun 5]. Available from: https://www.aapc.com/codes/icd-10-codes/I25.1
- Centers for Medicare & Medicaid Services. ICD-10-CM clinical concepts for cardiology [Internet]. Baltimore (MD): CMS; [cited 2025 Aug 14]. Available from: https://www.cms.gov/medicare/coding/icd10/downloads/icd10clinicalconceptscardiology1.pdf
- British Heart Foundation. Menopause and heart disease [Internet]. London: British Heart Foundation; [cited 2025 Jul 12]. Available from: https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease
- Kearney K. A ‘black box’: Asymptomatic stable ischemic CAD treated with PCI [Internet]. TCTMD; 2024 Apr 8 [cited 2025 Jun 5]. Available from: https://www.tctmd.com/news/black-box-asymptomatic-stable-ischemic-cad-treated-pci
- Zaid G, Yehudai D, Rosenschein U, Zeina AR. Coronary artery disease in an asymptomatic population undergoing a multidetector computed tomography (MDCT) coronary angiography. Open Cardiovasc Med J. 2010 Jan 29;4:7–13. doi:10.2174/1874192401004010007
- Wikipedia contributors. Coronary artery disease [Internet]. Wikipedia, The Free Encyclopedia; 2024 Mar 28 [cited 2025 Aug 14]. Available from: https://en.wikipedia.org/wiki/Coronary_artery_disease
- https://www.nejm.org/doi/full/10.1056/NEJMoa0907272
- Society of Nuclear Medicine. Many die of heart attacks without prior history or symptoms. ScienceDaily. 2008 Jun 16 [cited 2025 Aug 14]; Available from: https://www.sciencedaily.com/releases/2008/06/080616124938.htm
- Matta M, Harb SC, Cremer P, Hachamovitch R, Ayoub C. Stress testing and noninvasive coronary imaging: What’s the best test for my patient? Cleve Clin J Med. 2021;88(9):502–515. Available from: https://www.ccjm.org/content/88/9/502
- Eisenberg MJ. Accuracy and predictive values in clinical decision-making. Cleve Clin J Med. 1995;62(5):311–316. Available from: https://www.ccjm.org/content/ccjom/62/5/311.full.pdf
- Webb CM, Collins P. Stable angina in young women. Eur Heart J. 2025 [Epub ahead of print, 4 Feb 2025; accepted 21 Aug 2025]. Available from: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaf728/8276836
- Sinha A, Dutta U, Rahman H, Demir O, De Silva K, Morgan H, Li Kam Wa M, Ogden M, Belford S, Ellis H. Rethinking the false positive exercise stress test in the context of coronary microvascular dysfunction. Eur Heart J. 2023 Nov;44(Suppl 2):ehad655.1256. Available from: https://doi.org/10.1093/eurheartj/ehad655.1256
- Philips Healthcare. Six technology factors that will address your challenges in delivering care to CAD patients. Philips.com. Available from: https://www.philips.com/c-dam/b2bhc/master/Specialties/cardiology/cad/eversana-editorial/six-technology-factors-to-solve-cad-care-challenges.pdf
