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Medical Author:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Author:

Dennis Lee, MD

Dennis Lee, MD

Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• Introduction
• What is atherosclerosis?
• What are coronary heart diseases (CHD)?
• What is angina pectoris?
• What is a heart attack?
• Ventricular fibrillation
• Heart failure
• What is cerebral vascular disease?
• Ischemic stroke
• Hemorrhagic stroke
• Transient ischemic attack (TIA)
• When does the coronary atherosclerosis process begin?
• Have most people done enough to prevent atherosclerosis and heart attacks?
• What are the risk factors for coronary atherosclerosis and heart disease?
• How can coronary atherosclerosis and heart attacks be prevented?
• Find a local Cardiologist in your town
• Heart Attack and Atherosclerosis Prevention Index

Well-known risk factors for coronary atherosclerosis and heart attacks are:

• Elevated levels of LDL cholesterol (the "bad" cholesterol) in the blood;
  
  
• Family history of early coronary heart disease, including a heart attack or sudden death before age 55 in the father or other male first-degree relative, or before age 65 in the mother or other female first-degree relative;
  
  
• Cigarette smoking;
  
  
• Diabetes mellitus;
  
  
• High blood pressure;
  
  
• Low levels of HDL (the "good" cholesterol) in the blood; and
  
  
• Sedentary lifestyle.

Less recognized but just as important risk factors for coronary atherosclerosis are:

• A preponderance of small LDL cholesterol particles in the blood. LDL cholesterol particles come in different sizes. The size of a person's LDL cholesterol particles is predominantly genetically inherited. The smaller LDL cholesterol particles are far more dangerous in causing atherosclerosis than the larger particles. The smaller LDL particles can penetrate the walls of the arteries more easily than the larger LDL particles. A person with an abundance of small LDL cholesterol particles in the blood has a significantly higher risk of heart attack and coronary atherosclerosis than someone with larger LDL cholesterol particles in their blood.
  
  
• Abnormally elevated blood levels of Lipoprotein A, (Lp(a)). Lp(a) is an LDL cholesterol particle that is linked chemically to a protein called apo(a). The level of Lp(a) in the blood is also genetically inherited. Men and women with elevated blood levels of Lp(a) have significantly higher rates of coronary atherosclerosis and heart attacks.
  
  
• Elevated homocysteine levels in the blood. Homocysteine is a metabolic by-product of animal protein. Tests are now available to measure homocysteine levels in the blood. Higher homocysteine levels in the blood are associated with atherosclerosis in coronary arteries and carotid arteries (arteries that supply blood to the brain).