Risk factors and likelihood of having coronary artery disease

What do my risk factors mean?

In general, the more risk factors for coronary artery disease (CAD) that you have, the greater your chance of developing CAD. It is important to remember that having a single risk factor or any combination of risk factors does not guarantee that you have CAD. Your doctor cannot diagnose you with CAD simply by assessing your risk factors. Instead, each risk factor only adds to your doctor's suspicion that you may already have CAD or may develop it in the future.

How important are my risk factors?

Not all risk factors are created equal. Some of them, such as smoking or high cholesterol, are strong risk factors, meaning that they significantly increase your risk of CAD. Some risk factors contribute to your risk of CAD but more in combination with other risk factors than by themselves. Your doctor considers the importance of each of your risk factors in determining your overall risk for CAD and how these risks fit into the diagnostic puzzle. For example, lack of exercise alone doesn't put you at risk for CAD, but a lack of exercise combined with high blood pressure and obesity is more worrisome.

How much testing will I need for CAD?

• A person with no risk factors and no symptoms is unlikely to have significant coronary artery disease. For this person, testing will probably not go any further than a simple medical history, physical exam, and perhaps blood tests to screen for high cholesterol.
• A person with a single, strong risk factor (such as high cholesterol) may not have any additional testing beyond the medical history and physical exam. However, the doctor may want to help treat the risk factor and assess the risk for heart disease every few years. Further testing may be needed if there are any significant changes.
• A person who has several risk factors (smoking, diabetes, high cholesterol, high blood pressure, strong family history) or one who has chest pain or other signs of coronary artery disease is more likely to have significant coronary artery disease. For this person, testing may be more extensive.