Condition Guide

Heart Disease (Coronary Artery Disease)

Name: Heart Disease: Types, Blood Tests & Risk Factors
Creator: Suman Konda
Published: 2026-07-05

Heart disease is the leading cause of death worldwide. Understanding your cardiac blood tests, cholesterol, troponin, BNP, and blood glucose, is your first step to protecting your heart.¹

Written by Suman Konda, Clinical Pharmacist · Based on peer-reviewed sources · Editorial policy · Not medical advice

Last reviewed and updated: 28 September 2026 · How we check our content

Quick answer

Heart disease is the leading cause of death worldwide, and coronary artery disease — plaque building up in heart arteries over decades — is its commonest form. Heart risk is the sum of all your numbers (cholesterol, blood pressure, glucose, smoking), not one of them. Most heart attacks come from plaques that rupture, not ones that slowly close the artery.

What heart disease is

Heart disease is an umbrella term for conditions affecting the heart and blood vessels. The most common form is coronary artery disease (CAD): fatty deposits (plaques) build up inside the coronary arteries over decades, narrowing them and reducing blood flow to the heart muscle. This process, called atherosclerosis, begins as early as the teenage years and progresses silently for decades before causing symptoms.¹

It begins as endothelial dysfunction — damage to the artery's inner lining — lets LDL cholesterol enter and become trapped in the arterial wall. Macrophages engulf oxidised LDL, become foam cells, and over decades a fibrous cap forms over the lipid core: the atherosclerotic plaque. Most heart attacks occur not from gradual narrowing to complete blockage, but from plaque rupture — when an inflamed plaque's fibrous cap tears, triggering immediate clot formation that occludes the artery.⁴ CAD can cause stable angina (chest pain on exertion), unstable angina (at rest), or complete blockage causing myocardial infarction.

Heart disease: myths vs facts

Heart risk is widely misunderstood. Here is what the evidence says:

MYTH A normal cholesterol means your heart is fine.

FACT Heart risk is the sum of all the numbers — cholesterol, blood pressure, blood sugar and smoking — reviewed as a package, not in isolation. People are regularly reassured by a normal cholesterol while ignoring the rest, yet most heart attacks come from plaques that rupture, which a single cholesterol reading cannot predict.

MYTH Heart attacks always cause crushing chest pain.

FACT Not always: sudden breathlessness without chest pain is common in women and diabetics, and some heart attacks present as faintness, nausea or pain in the jaw, neck or arm. Any of these with the warning signs below warrants emergency care.

MYTH Everyone over 50 should take daily aspirin.

FACT Low-dose aspirin is for secondary prevention only — those who have had a heart attack or stent. In primary prevention the bleeding risk generally outweighs the benefit. It is a doctor's decision, not a birthday milestone.

MYTH Statins are only for people with high cholesterol.

FACT Statins benefit anyone with established heart disease and those with above 10% ten-year cardiovascular risk, whatever the cholesterol. And lipoprotein(a) — a genetic risk factor — is not lowered by statins at all, which is why family history changes the work-up.²

MYTH Young people do not get heart disease.

FACT Atherosclerosis begins in the teenage years and progresses silently for decades. Youth delays symptoms, not the process — which is why risk factors in your 30s and 40s shape outcomes in your 60s.

MYTH Exercise after a heart scare is dangerous.

FACT Around 150 minutes of moderate exercise per week is associated with a substantially lower rate of cardiac events. After a cardiac event, structured cardiac rehabilitation — supervised, graded exercise — is among the most effective recovery interventions. Discuss the right programme with your doctor.

What to do next

Heart symptoms and heart risk follow different playbooks. Find yours:

Your situation	Sensible next step	When to seek emergency care
Chest pressure, squeezing or pain lasting over 15 minutes	Call emergency services immediately. Especially with spread to arm, jaw, neck or back, sweating, nausea or breathlessness.
Sudden breathlessness without chest pain (especially women, diabetics)	Treat as a possible cardiac emergency — call emergency services rather than waiting to see if it passes.
Risk factors but no symptoms	Ask your doctor for a 10-year ASCVD risk score, a lipid panel, blood pressure review and HbA1c. Know your numbers as a package.	—
Family history of early heart disease	Ask about a one-time lipoprotein(a) test — it is genetic, not lowered by statins, and changes the risk picture.	—
After a heart attack or stent	Cardiac rehabilitation, high-intensity statin therapy, and secondary-prevention medicines as prescribed — do not stop or adjust them on your own.	New chest pain, breathlessness or palpitations after the event.
Considering daily aspirin “just in case”	Discuss with your doctor first — it is for secondary prevention, and bleeding risk matters.	—

Cardiac blood test targets

The key cardiac blood tests and their targets:

Test	Target	Notes
Total cholesterol	<200 mg/dL	Borderline high: 200–239; high: ≥240
LDL cholesterol	<100 mg/dL (below 70 if very high risk)	The primary statin target²
HDL cholesterol	>60 mg/dL (men >40; women >50)	Protective: low HDL = higher risk
Triglycerides	<150 mg/dL	Raised by refined carbs, alcohol, diabetes
HbA1c	<5.7%	Diabetes doubles cardiovascular risk³
hs-CRP	<1.0 mg/L (low risk)	High-sensitivity CRP for vascular inflammation
Lipoprotein(a)	<30 mg/dL	Genetic risk factor; not lowered by statins
High-sensitivity troponin	Below 99th centile	Rise-and-fall pattern after chest pain confirms MI; measured serially

Heart attack warning signs

Call emergency services immediately if you experience:

Crushing, squeezing or pressure in the chest lasting more than 15 minutes
Pain spreading to the left arm, jaw, neck or upper back
Chest pain with sweating, nausea or shortness of breath
Sudden breathlessness without chest pain (common in women and diabetics)
Feeling faint or losing consciousness with any of the above

Practical notes

Keeping a dated log of your cardiac reports — lipid profiles, blood pressure readings, HbA1c, ECG summaries — makes trends visible in a way single values never can. A cholesterol reading that is drifting upward year after year tells a different story from one that has been stable for a decade, and doctors rely on that history when weighing next steps. Store your reports digitally or in a folder, in date order, and bring the full set — not just the latest one — to each cardiology visit.

Several everyday details change how cardiac results are interpreted, so note them before your appointment. List every medicine and supplement you take (including ayurvedic or over-the-counter ones), record whether you fasted before a lipid test and for how long, and mention any recent infections, since inflammation can temporarily distort cholesterol and hs-CRP readings. A family history of heart disease before age 55 in men or 65 in women is also worth flagging explicitly.

Lifestyle factors come up in almost every cardiology consultation, and it helps to arrive with honest numbers rather than estimates. Doctors typically discuss smoking status, alcohol intake, weekly physical activity, sleep patterns and stress — having rough figures ready makes the conversation concrete. None of this replaces prescribed treatment, but it gives your doctor the full picture needed to tailor advice to you.

Follow-up testing for cardiac risk is usually scheduled at intervals your doctor sets based on your overall risk — often every 3 to 6 months when treatment has recently changed, and annually once values are stable. Repeating a lipid profile at the same lab, under the same conditions (fasting state, similar diet in the preceding weeks), makes comparisons meaningful. A single improved or worsened value matters less than the direction of the trend.

In India

A basic lipid profile in India typically costs in the ballpark of ₹300–₹600, while specialised cardiac markers such as hs-CRP, troponin or NT-proBNP generally range from a few hundred to a few thousand rupees — though prices vary by city and lab, and packages that bundle several tests are often cheaper than ordering them individually.

NABL-accredited laboratories are the safest choice for cardiac tests, and most major labs in Indian cities offer home sample collection with digital reports — convenient for repeat monitoring. Whatever the lab, the reference range printed on your own report is the one that counts, because cut-offs can differ slightly between assay methods.

Frequently asked questions

What is heart disease?

Heart disease is an umbrella term for conditions affecting the heart and blood vessels. The most common form is coronary artery disease (CAD): fatty deposits (plaques) build up inside the coronary arteries over decades, narrowing them and reducing blood flow to the heart muscle. This process, atherosclerosis, begins as early as the teenage years and progresses silently for decades before causing symptoms.

What are the warning signs of a heart attack?

Call emergency services immediately for: crushing, squeezing or pressure in the chest lasting more than 15 minutes; pain spreading to the left arm, jaw, neck or upper back; chest pain with sweating, nausea or shortness of breath; sudden breathlessness without chest pain (common in women and diabetics); or feeling faint or losing consciousness with any of the above.

What is an ASCVD risk score?

The ASCVD (atherosclerotic cardiovascular disease) risk score estimates your 10-year risk of a heart attack or stroke from age, sex, cholesterol, blood pressure, diabetes and smoking. Above 10% ten-year risk, guidelines generally favour statin therapy — ask your doctor to calculate yours, since treatment decisions hinge on total risk, not one number.

What is lipoprotein(a) and should I be tested?

Lipoprotein(a) — Lp(a) — is a genetic cholesterol risk factor: a level above about 30 mg/dL raises cardiovascular risk, and it is not lowered by statins. Because it is inherited, a single test in a lifetime is usually enough, and it is particularly worth checking with a family history of early heart disease.

Should everyone take daily aspirin for the heart?

No. Low-dose aspirin is for secondary prevention only — people who have already had a heart attack or stent. For primary prevention in people without established disease, the bleeding risk generally outweighs the benefit. Do not start aspirin on your own; discuss it with your doctor.

How often should I get my cholesterol checked once I'm on treatment?

That is a decision for your doctor, but a common pattern is a repeat lipid profile a few months after starting or changing treatment, then at longer intervals once values are stable. The goal of repeat testing is to track the trend and check that treatment is still appropriate — discuss a schedule that fits your overall risk.

Can I compare cholesterol reports from two different labs?

Only cautiously. Different labs may use different assay methods and reference ranges, so a small shift between two labs can reflect the method rather than a real change. For tracking trends, it is best to use the same lab where possible, and always go by the reference range printed on each individual report — your doctor can help you interpret mixed-lab histories.

Should I fast before a lipid profile test?

Fasting requirements depend on the lab and the reason for the test — triglycerides are the component most affected by a recent meal. Your lab will state whether fasting is needed, and if you are comparing with an earlier report, keep the conditions the same. Mention fasting status when you hand the report to your doctor.

What should I carry to my first cardiologist appointment?

Bring all recent blood reports in date order, a list of your current medicines and supplements, recent blood pressure readings if you have them, and a note of family history of heart disease. These give the doctor a head start and often reduce the need for repeat testing — ask what else the clinic would like you to bring.

References

Sources cited on this page. PubMed links open the original abstract.

Roth GA, Johnson C, Abajobir A, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017;70(1):1–25. PMID 28527533 · doi:10.1016/j.jacc.2017.04.052
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC guideline on the management of blood cholesterol. J Am Coll Cardiol. 2019;73(24):e285–e350. PMID 30423393 · doi:10.1016/j.jacc.2018.11.003
Norhammar A, Tenerz A, Nilsson G, et al. Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet. 2002;359(9324):2140–2144. PMID 12090978 · doi:10.1016/S0140-6736(02)09089-X
Coronary Artery Disease. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK564304

Medical Disclaimer: This page is for general educational purposes only and does not constitute medical advice. Always consult a qualified doctor for diagnosis and treatment.