Heart disease is a general term that refers to conditions that affect the heart and blood vessels. It includes several specific conditions such as coronary artery disease (CAD), heart failure, arrhythmias (irregular heartbeat), and heart attacks.

Heart disease remains the top cause of death in the United States. Some types can be difficult to detect early on, earning them the label “silent killers.” While the exact cause depends on the specific condition, common risk factors include high blood pressure, diabetes, smoking, poor diet, and excessive alcohol use.

Common Causes of Heart Disease

Because “heart disease” includes many different heart-related conditions, causes can vary. One of the most widespread forms—coronary artery disease (CAD)—develops when plaque builds up in the arteries, restricting blood flow to the heart.

Plaque is made of cholesterol, calcium, and other substances. As it accumulates in your arteries, it can block the flow of oxygen-rich blood, raising your risk of heart attacks and other complications.

The most common causes of plaque buildup include:

High Blood Pressure

Elevated blood pressure forces your heart to work harder, which can damage arteries over time and accelerate the narrowing of blood vessels. This makes it more difficult for blood to reach your heart, increasing your risk of developing heart conditions.

High Cholesterol

Your body needs some cholesterol to function, but too much LDL (“bad” cholesterol) can cause fatty deposits to form in your arteries. These blockages reduce circulation and increase the chance of heart problems.

Smoking

Tobacco use inflames the blood vessels and contributes to arterial narrowing. Even exposure to secondhand smoke has been linked to an increased risk of heart disease.

Medical Conditions That Raise Risk

Several health problems can also increase your likelihood of developing heart disease:

Diabetes

In diabetes, excess sugar builds up in the bloodstream due to inadequate insulin. Over time, this can damage blood vessels and nerves that control the heart. People with diabetes are also more prone to high blood pressure and cholesterol.

Kidney Disease

Your kidneys filter waste from the blood. If they’re not working properly, harmful substances like calcium and cholesterol may accumulate, potentially leading to clogged arteries.

Autoimmune Diseases

Conditions like lupus, rheumatoid arthritis, and Crohn’s disease can trigger chronic inflammation, which may affect the heart and blood vessels. These conditions are often linked with other heart disease risks like hypertension and diabetes.

Lifestyle Risk Factors

Certain habits and behaviors can also contribute to heart disease. The good news? Many are within your control.

  • Obesity: Excess weight increases the risk of high blood pressure, cholesterol, and diabetes.
  • Unhealthy Diet: Diets high in salt, sugar, and unhealthy fats contribute to cardiovascular issues.
  • Physical Inactivity: A sedentary lifestyle (e.g., sitting most of the day) raises your risk. The American Heart Association suggests 150 minutes of moderate physical activity per week.
  • Excessive Alcohol: Overdrinking can weaken the heart muscle and raise blood pressure.
  • Sleep Deprivation: Adults should aim for 7–8 hours of sleep each night. Poor sleep is linked to higher blood pressure, weight gain, and insulin resistance.
  • Chronic Stress: Poorly managed stress can lead to unhealthy coping behaviors such as smoking, drinking, overeating, or avoiding exercise.

Is Heart Disease Genetic?

Yes, genetics can play a role. If your parents have a history of heart disease, your own risk may be higher. Even if heart disease runs in your extended family, you might still face elevated risk.

The CDC advises gathering details about your family’s heart health—including when they were diagnosed—to help healthcare providers monitor your risk more closely.

Some people are born with congenital heart defects (CHD), which can be genetic or related to conditions during pregnancy. Risk is higher if:

  • One or both parents have CHD
  • The birthing parent had diabetes or rubella
  • The parent smoked or drank during pregnancy

Who Is at Risk?

Heart disease affects people of all ages and backgrounds, but certain factors beyond your control can raise your risk.

Sex

Men are generally more likely to experience heart issues earlier, while women's risk rises after menopause. Women are also more likely to die from heart disease once it develops.

Age

Risk increases with age. While CHD can affect infants, most heart disease-related deaths occur after age 65.

Race and Ethnicity

Black Americans face higher rates of hypertension and heart disease. People of Latin American, Indigenous, Asian, and Pacific Islander backgrounds also show increased risk.

However, race itself isn’t a biological risk factor—systemic barriers such as healthcare access, food insecurity, and healthcare discrimination often play a major role in increased risk among marginalized communities.

A Quick Summary

Heart disease includes many conditions that damage the heart or blood vessels. A key contributor is plaque, which forms due to high blood pressure, high cholesterol, and smoking. Diseases like diabetes and kidney problems also add to the risk, as do lifestyle choices such as inactivity, poor diet, and stress.

While age, sex, and race are factors you can't control, many other risk factors are manageable. If you suspect you’re at risk or notice symptoms, speak with your healthcare provider to explore testing and prevention strategies.