Heredity or Environment: Coronary Artery Disease (CAD)

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There are a variety of factors that can cause atherosclerosis. Genetics, environment and your lifestyle are the primary actors. Complex interactions among your genes involve the entire circulatory system including coronaries, carotids, and peripheral vessels.

In her article published in Medical News Today, Hannah Nichols states; “Heart disease remains the leading cause of death in the U.S., accounting for almost 1 in every four deaths…” (2017, February 23).

CAD is responsible for approximately a million and a half new heart attacks and five hundred thousand deaths each year. Experts predict that by the year 2020 CAD will become the leading cause of morbidity and mortality worldwide.

Studies over the last two decades provide evidence that genetics plays a significant part in the susceptibility of CAD. A study led by Kristina Sundquist and published in the American Heart Journal revealed that if one or both of your biological parents had some form of CAD, you have an increased risk of between 40 and 60% of having heart problems (2011, August 28).

What if I Get CAD?

Susceptibility doesn’t mean zero control of preventing the disease because choosing a healthy lifestyle can make an enormous difference. Genetic transference only means increased risk, and even if you begin to suffer from CAD, that doesn’t mean an automatic death sentence.

Advances in the treatment options for all types of heart disease have improved outcomes over the last several years. For example, one of the most severe heart disease problems, carotid stenosis, is when the carotid arteries become narrowed by a build-up of plaque. You have two carotid arteries, one on either side of your neck. These are major blood vessels whose job is supplying blood (oxygen) to the brain, neck, and face.


When plaque clogs your arteries, you are at a much higher risk of blood clots or stroke. Traditionally the treatment for severe conditions of blocked carotid arteries involved a carotid endarterectomy, a procedure that follows the following steps explained by the American Heart Association:

•    The doctor makes a small cut in your neck at the spot where your carotid artery is blocked or narrowed.

•    The doctor opens the narrowed artery and removes the plaque.

•    The doctor will make the vessel as smooth and clean as possible.

•    The final step is closing the surgical cuts (sutured).

•    The surgery takes about one or two hours. (2015, American Heart Association)

A more advanced and less invasive method for repairing carotid stenosis is carotid artery stenting (CAS). Carotid Stenting involves placing a small, balloon-like tube in the artery. During this procedure, the doctor threads a catheter through the femoral artery to the carotid arteries. The stent is then fed through the catheter until it reaches its destination, is inflated, and widens the artery.


Experts agree that heart disease is the number one cause of death in the United States. Coronary Artery Disease is a significant percentage of what causes morbidity and mortality. Genetics plays an influential role along with your environment and lifestyle. You can’t control your genes; however, making the right choices about environmental factors (diet, exercise, quit smoking) can protect you from your genetic susceptibility. Protect your heart, protect your health.