Coronary Heart Disease: Surprising New Risk Factors

By Marc Gillinov, MD, Cardiac Surgeon at Cleveland Clinic and StevenNissen, MD, Chairman of the Department of Cardiovascular Medicine at Cleveland Clinic Dr. Gillinov and Dr. Nissen are authors of Heart 411: The Only Guide to Heart Health You’ll Ever Need

Posted on | By Marc Gillinov, MD, Steven Nissen, MD

Coronary heart disease (also called coronary artery disease or coronary atherosclerosis) is characterized by cholesterol-filled plaques that block arteries and can cause chest pain (angina) or heart attacks. As with every medical condition, the development of coronary heart disease depends upon the presence of predisposing conditions or behaviors, known as risk factors. The more risk factors that you have, the greater the likelihood that you will end up in a hospital with chest pain or a heart attack. On the other hand, if you recognize these risk factors and reduce them as much as possible, you may never need to see a heart doctor.

Risk Factors: The Usual Suspects

While some basic risk factors are beyond your control – advancing age, a family history of heart disease – others are completely up to you. Most people are aware of the usual suspects leading to coronary heart disease: high blood pressure, diabetes, obesity, tobacco use, lack of exercise, and abnormal cholesterol levels. Managing these risk factors can go a long way toward reducing your risk of coronary heart disease.

Risk Factor

Can You Change It

Your Goal

High blood pressure


BP 120/80 or less



LDL less than 130

Tobacco use


Quit smoking


Yes, if Type II

Lose weight with diet and exercise

Lack of exercise


Exercise 30 minutes a day



Mediterranean diet, watch calories, exercise daily

Family history


Be aware of your family history

Advanced age


Control the risk factors you can beginning as early as possible—That means starting right now!

The “New” Risk Factors

In the last few years, scientists have extended our understanding of the genesis of heart disease. We now recognize a host of factors and conditions with previously unsuspected links to heart disease, including inflammatory diseases, gum disease, air pollution and even sleep problems. While the link between these emerging risk factors is not as strong as the association between heart disease and high blood pressure, cholesterol or tobacco use, a growing body of evidence supports their relationship to the development of heart disease.

Article written by Marc Gillinov, MD
Cardiac Surgeon at Cleveland Clinic

Article written by Steven Nissen, MD
Chairman of the Department of Cardiovascular Medicine at Cleveland Clinic