Coronary heart disease

Coronary heart disease (CHD) is the leading cause of death in the UK. It occurs when the coronary arteries, which supply blood to the heart muscle, become narrowed or blocked by a build-up of fatty deposits (atherosclerosis).

CHD develops over many years and may not cause symptoms until the arteries are significantly narrowed. Symptoms can include angina (chest pain on exertion), shortness of breath and, in the most serious cases, a heart attack.

Risk factors include high cholesterol, high blood pressure, smoking, diabetes, obesity, physical inactivity and a family history of heart disease.

Beyond standard lipid tests, markers such as high-sensitivity CRP (hs-CRP) measure low-grade vascular inflammation, and lipoprotein(a) identifies a genetic risk factor that standard cholesterol tests do not capture. The PLAC test (Lp-PLA2) assesses arterial inflammation associated with unstable plaque, offering additional cardiovascular risk information.

Causes of Coronary heart disease

Coronary heart disease is caused by atherosclerosis, the gradual build-up of fatty deposits (plaques) within the walls of the coronary arteries. This process begins with damage to the inner lining of the artery and progresses over decades.

The major modifiable risk factors are:

Smoking, which damages artery walls and accelerates plaque formation
High blood pressure, which increases the force on artery walls
High cholesterol, particularly elevated LDL cholesterol and lipoprotein(a)
Type 2 diabetes, which damages blood vessels through chronic glucose elevation
Obesity and physical inactivity
Unhealthy diet high in saturated fat, salt and refined sugars

Non-modifiable risk factors include age, male sex, family history of early heart disease and ethnicity. South Asian populations have a higher incidence of CHD compared to the general UK population.

Tests that can help check this condition

PLAC® (Lp-PLA2)

Learn more on the official NHS page .

Medical review

Dr. Shahzaib Ahmad MBBS, BSc, MRCP, FRCA, FFICM

Clinical Supervisor - Vitall|GMC 7495062|Profile

Dr Shahzaib Ahmad is a Consultant in Intensive Care Medicine with subspecialty experience in cardiac critical care and neurocritical care. He has extensive experience managing complex acute and cardiovascular conditions in hospital intensive care settings. Dr Ahmad supports Vitall in reviewing health content for clinical accuracy and alignment with current medical practice.

Reviewed on 22/05/2026

Next review due 22/05/2027

Review focus: Blood biomarkers, laboratory testing methodology, and biochemical interpretation.

This content has been reviewed for medical and scientific accuracy but does not replace advice from a qualified healthcare professional.