Coronary Heart Disease: Symptoms, Risk Factors, and What Medicare Covers (2026)

Coronary heart disease (CHD) is still the leading cause of heart disease deaths in the United States, but the warning signs are well understood and many risk factors are manageable. The short version: CHD happens when the arteries feeding your heart become narrowed by plaque buildup, it’s responsible for roughly 1 in 3 cardiovascular deaths, and knowing your risk factors — along with the preventive care Medicare covers — can meaningfully change your outlook. Here’s what the latest data shows and what steps to take.

What is coronary heart disease, exactly?

Coronary heart disease, also called coronary artery disease, develops when the coronary arteries — the blood vessels that supply oxygen-rich blood to the heart muscle — become narrowed or blocked by a buildup of fatty deposits called plaque, a process known as atherosclerosis. As the arteries narrow, less oxygen reaches the heart muscle, which can cause chest discomfort (angina) and, if a plaque ruptures and blocks blood flow entirely, a heart attack. The CDC’s current guidance on coronary artery disease describes this narrowing process as the underlying cause of most heart attacks in the U.S.

How common is coronary heart disease today?

More common than most people realize. According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics update, cardiovascular disease caused 915,973 deaths in the United States in 2023, and coronary heart disease alone was responsible for 349,470 of those deaths — making it the single leading cause of cardiovascular death, accounting for 38.2% of all CVD deaths that year. Put another way, someone in the U.S. has a heart attack roughly every 40 seconds. The AHA also reports that CHD currently affects about 5.2% of U.S. adults — roughly 15.9 million people — and prevalence rises sharply with age: among adults ages 60–79, about 18.4% of men and 8.5% of women have CHD, and among those 80 and older, that climbs to 32.5% of men and 20.6% of women.

There is real encouraging news in the data, too: the age-adjusted CHD death rate declined nearly 20% between 2013 and 2023, reflecting real progress in prevention, early detection, and treatment — even though the total number of deaths has declined more modestly because the population of older adults has grown.

What are the warning signs of coronary heart disease or a heart attack?

Per the CDC and Mayo Clinic, watch for:

• Angina — chest pain or pressure, often described as tightness, squeezing, or heaviness under the breastbone.
• Atypical pain — discomfort in the arm, shoulder, jaw, neck, or back, which is a more common presentation in women than the classic chest-pain pattern.
• Shortness of breath, especially with exertion.
• Weakness, lightheadedness, nausea, or a cold sweat — these can accompany a heart attack, particularly in women and older adults.

If you or someone near you experiences sudden chest pain along with any of these symptoms, call 911 immediately — don’t wait to see if it passes.

What raises my risk of coronary heart disease?

According to the CDC’s heart disease risk factor guidance, three conditions drive most of the risk: high blood pressure, high cholesterol, and smoking — and about 47% of American adults have at least one of these three key risk factors. Other contributors include diabetes, obesity, physical inactivity, excessive alcohol use, a diet high in saturated fat and sodium, and family history of early heart disease. Age itself is also a major factor: risk rises steadily after age 45 for men and 55 for women, and CHD prevalence roughly triples between ages 60 and 80, per AHA data.

Ask yourself honestly:

• Do I have a parent or sibling who had a heart attack or heart disease at a young age?
• Do I currently smoke, or have I smoked in the past?
• Do I have high blood pressure or high cholesterol?
• Am I living with diabetes or prediabetes?
• Am I carrying excess weight, particularly around the midsection?
• Do I get regular physical activity, or is my lifestyle mostly sedentary?

Answering “yes” to several of these doesn’t mean a heart attack is inevitable — it means these are exactly the risk factors your primary care doctor can help you manage with regular screening and, if needed, medication.

How can coronary heart disease be prevented or managed?

The CDC’s prevention guidance emphasizes controlling blood pressure and cholesterol, not smoking, staying physically active, eating a heart-healthy diet, maintaining a healthy weight, and managing diabetes closely if you have it. Routine screening matters too — blood pressure and cholesterol checks are quick, low-cost ways to catch rising risk before it becomes a crisis, which is exactly why annual wellness visits and preventive screenings matter as you get older.

What does Medicare cover for heart health?

Medicare Part B covers a range of preventive services relevant to coronary heart disease, generally at no cost when you see a provider who accepts Medicare, including cardiovascular disease screening blood tests, an annual wellness visit, and diabetes screenings for those at risk. If you’re diagnosed with heart disease, Part B also covers medically necessary services like cardiac rehabilitation and visits to a cardiologist, subject to your plan’s normal cost-sharing rules. If you have a Medicare Advantage plan, many plans include additional wellness or fitness benefits — like a gym membership program — that can support heart-healthy habits, so it’s worth checking your plan’s supplemental benefits.

What You Should Do Now

• Schedule an annual wellness visit and ask specifically about blood pressure and cholesterol screening if you haven’t had one recently.
• Review the risk factor questions above honestly, and bring any concerns to your primary care doctor.
• Know the warning signs of a heart attack, including the atypical symptoms more common in women, and don’t hesitate to call 911.
• If you’re managing diabetes, high blood pressure, or high cholesterol, ask your doctor whether your current care plan and medications are keeping you on track.
• Check whether your Medicare Advantage plan includes fitness or wellness benefits that can support a heart-healthy lifestyle — and if you’re unsure what your plan covers, a licensed advisor can help you review it.

Frequently Asked Questions

Is coronary heart disease the same as a heart attack?

No. Coronary heart disease is the underlying narrowing of the arteries; a heart attack happens when blood flow to part of the heart is suddenly blocked, often because of a ruptured plaque, and is one possible consequence of untreated CHD.

Does Medicare cover cholesterol and blood pressure screening?

Yes. Medicare Part B covers cardiovascular disease screening blood tests, and blood pressure is checked as part of your covered annual wellness visit.

Are heart attack symptoms different for women?

Often, yes. Women are more likely than men to experience atypical symptoms like back, jaw, or arm pain, shortness of breath, nausea, or fatigue without the classic crushing chest pain, according to the CDC and Mayo Clinic.