What is heart disease?
Heart disease is an umbrella term for conditions affecting the heart and blood vessels. The most common form is coronary artery disease (CAD) — where fatty deposits (plaques) build up inside the coronary arteries over decades, narrowing them and reducing blood flow to the heart muscle. This process, called atherosclerosis, begins as early as the teenage years and progresses silently for decades before causing symptoms. CAD can cause stable angina (chest pain on exertion), unstable angina (at rest), or complete artery blockage causing a heart attack (myocardial infarction).
Blood tests for cardiac risk assessment
| Test | Optimal | Notes |
|---|---|---|
| Total Cholesterol | <200 mg/dL | Borderline high: 200–239; High: ≥240 |
| LDL Cholesterol | <100 mg/dL (lower if high risk) | The primary statin target; <70 if very high risk |
| HDL Cholesterol | >60 mg/dL (men >40; women >50) | Protective — low HDL = higher risk |
| Triglycerides | <150 mg/dL | Raised by refined carbs, alcohol, diabetes |
| Fasting blood glucose | 70–100 mg/dL | Diabetes doubles cardiovascular risk |
| HbA1c | <5.7% | Long-term glucose control |
| hs-CRP | <1.0 mg/L (low risk) | High sensitivity CRP for vascular inflammation |
| Lipoprotein(a) [Lp(a)] | <30 mg/dL | Genetic risk factor; not lowered by statins |
Heart attack warning signs
Call emergency services immediately if you experience:
- Crushing, squeezing or pressure in the chest lasting >15 minutes
- Pain spreading to the left arm, jaw, neck or upper back
- Chest pain with sweating, nausea or shortness of breath
- Sudden breathlessness without chest pain (common in women and diabetics)
- Feeling faint or losing consciousness with any of the above
Cardiac risk factors you can control
- High LDL cholesterol — target <100 mg/dL (<70 if very high risk)
- High blood pressure — target <130/80 mmHg
- Type 2 diabetes — HbA1c <7%
- Smoking — doubles heart attack risk; quitting reduces risk within 1 year
- Obesity — especially abdominal fat
- Physical inactivity — 150 minutes moderate exercise per week halves cardiac events
- Chronic stress and poor sleep
Prevention — medications that protect the heart
| Medication | Who benefits |
|---|---|
| Statins (atorvastatin, rosuvastatin) | Anyone with established heart disease; those with >10% 10-year risk |
| Aspirin (low dose) | Secondary prevention only — those who have had a heart attack or stent |
| ACE inhibitors / ARBs | Heart failure, post-MI, hypertension, diabetes with proteinuria |
| Beta-blockers | Post-MI, heart failure, arrhythmias |
| SGLT2 inhibitors (empagliflozin, dapagliflozin) | Diabetes with heart disease — proven cardiac mortality benefit |
Questions to ask your doctor
- What is my 10-year cardiovascular risk (ASCVD score)?
- Should I start a statin?
- Do I need a stress test or calcium scoring CT scan?
- What is my Lp(a) level?
- Should I take aspirin?
Medical Disclaimer: This page is for general educational purposes only and does not constitute medical advice. Always consult a qualified doctor for diagnosis and treatment.