What Causes Heart Disease?

Heart disease is an umbrella term that describes any heart condition that affects the functioning of your heart and its blood vessels. Several heart conditions fall under heart disease. These conditions include coronary artery disease (CAD), heart arrhythmias (irregular heartbeat), heart attack, and heart failure, among others. 

Heart disease is the leading cause of death in the United States. Unfortunately, some heart diseases can be “silent killers,” meaning you don’t notice any symptoms until the condition progresses. The causes of heart disease depend on the type of heart condition that you have. But, conditions such as high blood pressure and diabetes, excessive alcohol and tobacco use, and eating a poor diet can increase your risk for a number of heart diseases.

woman sitting on park bench holding her heart with chest pain

Emir Memedovski / Getty Images


Because heart disease encompasses different types of heart conditions, the exact cause(s) will depend on the type of heart disease that you have. The most common heart disease is a condition called coronary artery disease (CAD), which limits blood flow to the heart

There is one primary suspect for CAD and similar heart conditions: plaque build-up. Plaque is a fatty and waxy substance that is made up of cholesterol, calcium, and other minerals. When plaque begins to grow in your heart’s arteries (blood vessels), it can restrict blood flow and block oxygen from going to and from the heart. 

High blood pressure, high cholesterol, and smoking are the most common contributors to plaque buildup in your heart.

  • High blood pressure: Blood pressure is the amount of force your blood puts on the walls of your arteries as blood flows through them. If your blood pressure is high, your heart needs to pump harder to push blood through your arteries. This extra force and pressure in your heart can accelerate plaque build-up can damage your arteries. As a result, the arteries start to narrow, making it difficult for your heart to pump blood and putting you at an increased risk for heart disease.
  • High cholesterol: Not all cholesterol is bad for you—in fact, you need good cholesterol to help your body make cells and hormones. There are two types of cholesterol: high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol. HDL cholesterol is known as “good” cholesterol, while LDL cholesterol is known as “bad” cholesterol. An excess of LDL cholesterol can lead to plaque buildup and limit the function of your arteries.
  • Smoking: The chemicals in cigarettes and other forms of tobacco can cause inflammation in the arteries. When your arteries become inflamed, they begin to narrow and increase the risk of developing plaque build-up. Research also suggests that people who have been exposed to secondhand smoke (or, inhaling smoke from someone else’s cigarettes) can also have a higher risk of developing heart disease.

Condition-Related Risk Factors 

Having other health conditions can also increase your risk of developing heart disease. 

  • Diabetes: Diabetes occurs when your pancreas cannot produce enough insulin—a hormone that helps your body turn glucose (or, sugar) into energy. As a result, too much glucose in your body for long periods of time can lead to significant organ damage, including problems with your heart and its arteries. People with diabetes are also more likely to have high blood pressure and high cholesterol—two culprits of plaque build-up in your heart.
  • Kidney disease: People who have a kidney disease diagnosis are also at an increased risk for developing heart disease. Your kidneys are responsible for filtering out your blood. When your kidneys become impaired, harmful waste can build up in your blood vessels—including cholesterol and calcium deposits, which can lead to a blockage in your arteries.
  • Autoimmune diseases: Autoimmune conditions, such as rheumatoid arthritis, Crohn’s disease, or lupus cause inflammation in your body. If these conditions progress, inflammation can reach the heart and affect the functioning of your blood vessels. Research also suggests that people with autoimmune conditions also have traditional risk factors of heart disease, such as diabetes and high blood pressure.

Lifestyle Risk Factors 

Certain lifestyle habits can make you vulnerable to developing some types of heart diseases, like CAD. The good news is that in most cases, you have some level of control over these risk factors and can make adjustments to your lifestyle to lower your risk of disease.  

  • Obesity: People who are obese are more likely to develop heart disease because they are at an increased risk of high blood pressure, high cholesterol, and diabetes.
  • Diet: Eating a diet high in salt, added sugars, and fat can lead to obesity, high blood pressure, and high cholesterol—resulting in an increased risk of heart disease.
  • Sedentary lifestyle: Not getting enough physical activity throughout the day (such as sitting for most of the day and walking less than 5,000 steps) may increase your heart disease risk. The American Heart Association recommends at least 150 minutes of moderate exercise weekly to reduce the risk of heart disease.
  • Alcohol use: Drinking too much alcohol can raise your blood pressure and make your heart muscle weak. Consuming alcohol is also tied to higher rates of developing an abnormal heart rhythm.
  • Lack of sleep: Sleep is important for both your energy throughout the day and the functioning of your heart. The Centers for Disease Control and Prevention (CDC) recommend that adults should get seven to eight hours of sleep each night. Lack of sleep can increase your risk of high blood pressure, type 2 diabetes, and obesity, which have all been linked to higher rates of heart disease.
  • Stress: Everyone deals with stress, but how you manage it can affect your heart health. Poor stress management may lead to behaviors such as smoking, drinking alcohol, eating too much or too little, and lack of physical activity. As a result of these behaviors, you may be more likely to develop high blood pressure, obesity, and high cholesterol, which can all increase your risk of heart disease.

Is Heart Disease Hereditary?

You are more likely to develop heart disease if one of your parents has heart disease. If relatives outside of your parents have heart disease, you are still at an increased risk of having a heart condition as well. 

The CDC recommends learning about your family history of heart disease and noting at what age your relatives received their diagnosis. This can help you and your healthcare provider to watch out for certain risk factors and monitor your heart health sooner.

Some people with heart disease have a condition called congenital heart disease (CHD)—a heart condition that occurs at birth. Medical researchers and clinicians don’t always exactly know why a baby develops a congenital heart defect, but some research points to a gene mutation and hereditary risk factors. 

A baby is at higher risk of developing CHD if:

  • One or both parents also have CHD 
  • One or both parents have a personal history of other health conditions such as diabetes or rubella 
  • The birthing parent smokes or drinks alcohol while pregnant 

Who Gets Heart Disease?

Heart disease is the leading cause of death in the United States. However, there are some heart disease risks that you have no control over. These include:

  • Sex: Men and women both can develop heart disease, but men have a higher risk of heart attacks and experience heart conditions earlier in life than women. However, the risk of heart disease for women increases after menopause, and women are more likely to die sooner because of heart disease if they do develop a condition. 
  • Age: Heart disease can develop at any age, including newborn babies with CHD. Generally, however, the older you are, the higher your risk of developing heart disease. Most people who die from heart disease do so over the age of 65. 
  • Race: Black people have disproportionately high rates of high blood pressure and heart disease, compared to other racial backgrounds. People from Latin American, Indigenous, Hawaiian, and Asian backgrounds also have higher rates of heart disease than white people. It’s important to note that race is not a risk factor. Rather, social factors such as systemic racism in health care, lack of insurance, and the higher costs of healthy food can make Black, Indigenous, and other People of Color (BIPOC) communities vulnerable to heart conditions. 

A Quick Review

Heart disease is an umbrella term that covers a wide range of heart and blood vessel diseases. The primary damage to your arteries’ function is plaque build-up. Plaque can develop because of high blood pressure, high cholesterol, and smoking. Other conditions such as diabetes, kidney disease, and autoimmune diseases can also raise your risk of heart disease. 

Some lifestyle factors, such as lack of physical activity, obesity, and eating a poor diet can also increase your risk of developing a heart condition. However, age, sex, and race are not modifiable risk factors—meaning, you can’t change them. 

If you think you may be at risk of heart disease or are experiencing symptoms, it’s good practice to talk to your healthcare provider. They can get you started on a diagnostic process and help you learn ways to lower your risk of disease development and progression. 

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15 Sources
Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. About heart disease

  2. Centers for Disease Control and Prevention. Coronary artery disease

  3. American Heart Association. Health threats from high blood pressure

  4. Centers for Disease Control and Prevention. Cholesterol myths and facts

  5. Centers for Disease Control and Prevention. Smoking and cardiovascular disease

  6. Centers for Disease Control and Prevention. Diabetes and your heart.

  7. National Institute of Diabetes and Digestive and Kidney Diseases. Heart disease & kidney disease

  8. American Heart Association. People with rheumatoid arthritis, other autoimmune diseases may face greater risks after heart attack.

  9. Centers for Disease Control and Prevention. Know your risk for heart disease

  10. American Heart Association. How to sneak in healthy physical activity during a sedentary work day.

  11. Centers for Disease Control and Prevention. How does sleep affect your heart health?

  12. American Heart Association. Stress and heart health

  13. Centers of Disease Control and Prevention. Does heart disease run in your family? 

  14. National Heart, Lung, and Blood Institute. Congenital heart defects causes and risk factors.

  15. American Heart Association. Understand your risks to prevent a heart attack.

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