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Some people have severe symptoms of coronary heart disease. Others have no symptoms at all. If you have “silent” coronary heart disease, you may not have any symptoms until you have a heart attack or other complication.

You should start getting screening tests and risk assessments for coronary heart disease around age 20 if you do not have any risk factors for coronary heart disease. Children may need screening if they have risk factors, such as obesity, low levels of physical activity, or a family history of heart problems. Afterward, your doctor may recommend preventive treatments such as heart-healthy lifestyle changes to help you lower your risk of coronary heart disease.

There are three main types of coronary heart disease: obstructive coronary artery disease, nonobstructive coronary artery disease, and coronary microvascular disease. Coronary artery disease affects the large arteries on the surface of the heart. Many people have both obstructive and nonobstructive forms of this disease. Coronary microvascular disease affects the tiny arteries in the heart muscle.

There are many risk factors for coronary heart disease. Your risk of coronary heart disease goes up with the number of risk factors you have and how serious they are. Some risk factors—such as high blood pressure and high blood cholesterol—can be changed through heart-healthy lifestyle changes. Other risk factors, such as your sex, older age, family history and genetics, and race and ethnicity, cannot be changed.

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