What Is Heart Disease?

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The term "heart disease" cuts across a number of health conditions, including valve and rhythm problems, but, as George Rodgers, MD, a clinical cardiologist at the Austin Heart Cardiology Group and chairman of the Governors of the American College of Cardiology explained, "when we're talking about heart disease, in America really we're talking about atherosclerosis, or the tendency to form plaque in the arteries." Atherosclerosis is also sometimes called coronary artery disease.
Coronary artery disease can also cause angina — chest pressure or tightness associated with shortness of breath that occurs during exercise — and it is the leading cause of heart attacks.
Who Gets Heart Disease?

Heart disease affects men and women alike, though men usually develop the disease earlier than their female counterparts — men in their early 60s and 70s, women, on average, around 10 years later. The later onset in women is thought to be due to the protective effects of the hormone estrogen, which women have in abundance through their childbearing years and which gradually declines after menopause.

What Causes Heart Disease?
"Heart disease is caused by an inflammatory process that is the result of a number of different factors," said Dr. Rodgers. Some of the biggest culprits are cholesterol, nicotine from smoking cigarettes, LDL particles from cholesterol, and high levels of glucose (blood sugar). All of these irritants can inflame the delicate lining of the arteries. In response to the inflammation, the arteries start to form plaque. "It's kind of like the same idea as that little grain of sand that gets inside the oyster shell and then the oyster forms a pearl around it," Rodgers explained. "Our body's defense against these little irritating things is to form this plaque, this tissue."
A heart attack occurs when that plaque becomes so inflamed that it ruptures, breaking off and forming a clot that blocks the artery and cuts off the blood flow to the heart. "In about 50 percent of the cases, that blockage leads to a fatal rhythm problem and they die suddenly," said Rodgers. "The other 50 percent of the cases need to be rushed to the hospital for treatment. We give them a drug to dissolve that clot, angioplasty to open up that artery, or surgery."
How Can Heart Disease Be Reversed or Prevented?
"The best way to prevent heart disease is by eating a great diet: high in Omega-3 fish oils, low in trans fats and the bad fats, with plenty of fruits, vegetables, and fiber, and no fried, greasy foods," Rodgers advised. "Also, aim for 150 minutes of moderate to vigorous activity a week and maintain as close to an ideal body weight as you can."

"Reversing the disease is tougher," Rodgers continued, "but people who really get really strict with their diet and exercise and do all the right lifestyle things can shrink plaque. They may not be able to completely erase it, but as long as you prevent the progression and stabilize the plaque so it's no longer inflamed and not likely to rupture, then you've really accomplished a lot. Of course, there's some genetic predisposition to heart disease. But I don't think it's inevitable — even though heart disease kills 25% of Americans, I don't think it's an inevitability of humanity."