Coronary artery disease (CAD) occurs when plaque builds up in the arteries that supply blood to the heart. Genetic factors likely play a role in the development of CAD.

CAD is a type of heart disease where the arteries are unable to deliver enough oxygen-rich blood to the heart. It occurs due to an accumulation of plaque in the arteries. Plaque consists of different deposits, which can include fatty substances and cholesterol.

When plaque accumulates in the walls of the arteries that supply blood to the heart, it may cause the arteries to narrow over time. This can block the flow of blood to the heart.

Many different lifestyle factors, such as poor diet and insufficient exercise, can increase a person’s risk of developing CAD. Additionally, growing evidence is highlighting the role of genetics, as having certain genes may increase a person’s susceptibility to CAD.

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Genetic factors contribute to a person’s risk of developing CAD.

The Centers for Disease Control and Prevention (CDC) state that a family history of certain heart diseases, including CAD, can increase a person’s risk of developing those diseases.

A 2022 twin study showed that certain factors that cause CAD have strong genetic heritability. This means that genetic factors play a role in their development.

These factors were coronary artery calcification and calcified plaque volumes. These terms refer to how much calcium is present in blood vessels, which can be a strong indicator of heart disease. However, the same study notes that environmental factors play a larger role in noncalcified plaque volume.

Studies show that at least 7 genes may play a role in the development of CAD. These genes include:

  • LPL: This gene encodes the enzyme lipoprotein lipase — which helps the body break down fat in the form of triglycerides.
  • APOC3: Encodes the protein component of triglyceride-rich lipoproteins. This protein can promote the secretion of certain bad cholesterol.
  • APOA5: This encodes a protein known as an apolipoprotein. This protein is important for regulating triglyceride levels in the blood. High triglyceride levels in the blood are a major risk factor for CAD.
  • ANGPTL4: This gene encodes a type of protein that helps to regulate glucose levels and lipid metabolism. It also plays a role in insulin sensitivity. Medical professionals also associate lower levels of this gene with type 2 diabetes.
  • ASGR1: Encodes part of a receptor that plays a role in maintaining a stable level of certain proteins in the serum — the clear liquid part of blood.
  • ANGPTL3: This encodes a protein that plays a role in the development of new blood vessels.
  • TRIB1: This gene enables binding activity in certain proteins. It also plays a role in a number of signaling pathways.

Studies suggest that race may also play a role in the development of CAD.

People with a higher risk of developing CAD include people who identify as:

  • Southeast Asian
  • Black
  • Hispanic
  • Latino

One reason for this may be due to inequities in healthcare.

Medical professionals often split risk factors for CAD into nonmodifiable and modifiable risk factors.

Nonmodifiable

Nonmodifiable risk factors for CAD include:

  • Age: CAD is more common in people who are older than 35 years old. The lifetime risk of CAD increases as a person gets older.
  • Sex: Males are at more risk of developing CAD than females.
  • Race: Studies suggest that people of certain races are at an increased risk of developing CAD. This may be due to inequities in healthcare.
  • Genetics: Family history is a significant risk factor for CAD.

Modifiable

Having certain medical conditions can increase a person’s risk of developing CAD. Medical professionals will refer to these medical conditions as modifiable risk factors, as a person may be able to manage the condition.

These health conditions include:

Environmental risk factors are another form of modifiable risk factor. Common environmental risk factors for CAD include:

A person can reduce their risk of CAD by following these steps:

  • eating a healthful diet that is high in:
    • vegetables
    • fruits
    • legumes
    • nuts
    • whole grains
    • fish
  • reducing the amount of saturated fats in their diet
  • being physically active
  • avoiding smoking if applicable

Studies also show that achieving good-quality sleep can lower a person’s risk of developing CAD.

Read on to learn more about whether CAD is reversible.

CAD occurs when plaque builds up in the arteries that supply blood to the heart. This plaque can cause the arteries to become narrow, which can block the flow of blood to the heart.

Genetic factors can play a role in the development of CAD. Having a family history of CAD may increase a person’s risk of developing the condition.

Other factors that can increase a person’s risk of developing CAD include increased age, being male, being of a certain race, and having certain health conditions, such as diabetes and high blood pressure.

A person may lower their risk of developing CAD by eating a heart-healthy diet, reducing the amount of saturated fats they consume, being physically active, and avoiding smoking if applicable.