Coronary Care: What Causes Coronary Heart Disease in the Elderly?

Written by Joe Newman04/12/19


Complex Care

Causes of coronary heart disease

The most common cause of coronary heart disease is damage to the coronary arteries due to a build-up of cholesterol on the walls of the blood vessels and creating fatty plaques. This condition is known as atherosclerosis, meaning there is a narrowing of the coronary arteries, resulting in a reduction of blood flow to the heart.

Like all the muscles in the body, the heart requires an adequate blood supply to function efficiently. When there is a reduction of blood flow, the heart is less able to pump blood around the body, especially when engaged in physical activity.

Other rarer causes of coronary heart disease include an embolism or clot in the blood vessel.

There are various risk factors for the build-up of cholesterol and other substances that can play a part in the development of coronary heart disease, such as:


If your loved one smokes, this puts them at higher risk of developing coronary heart disease. Smokers are at a 24% higher risk of developing the heart condition than non-smokers. Nicotine and carbon monoxide present in the smoke both put an increased strain on the heart, forcing it to work faster. Smoking also increases the risk of developing blood clots. Chemicals in cigarette smoke can damage the lining of the coronary arteries, and this can lead to the blood vessels becoming narrow.

If your loved one has private care or live-in care, it is vital to ensure that their carer is aware of any plans to reduce or stop smoking, so they can support them in this.


Another common risk factor in the elderly is hypertension or high blood pressure. High blood pressure can put an increased strain on the heart that can eventually lead to the development of coronary heart disease. It’s important to monitor your loved one’s blood pressure, and steps should be taken to ensure it remains at a lower level.

Diet plays a vital role in managing hypertension. Your loved one should reduce their salt intake through close monitoring of the foods they consume. If your loved one is unable to manage their diet themselves, for example, if they are receiving dementia care, a carer can ensure they follow a healthy diet. A live-in carer can also ensure that any prescribed antihypertensive medication is taken correctly

Colin and Dulcie’s story

Dulcie is 102-years-old and lives with her son Colin, his wife Mary, and her Carer Sarah. She has dementia and has had full-time live-in care for over two years.

We talk to the family about the challenges of finding the right care solution for a fiercely independent woman – and how the positive benefits of live-in care with Sarah has transformed all of their lives.



Cholesterol levels should be checked regularly as part of your relative’s ongoing elderly care regime by their doctor, particularly if there are any known coronary care concerns. Although the body needs some cholesterol for healthy cells, too much in the blood can lead to coronary heart disease. The amount of saturated fat in your loved one’s diet should be carefully observed.


People with diabetes are also at increased risk of atherosclerosis, and their blood sugar levels must be carefully controlled to prevent the condition from accelerating. Diabetes can cause the lining of the blood vessels to thicken, restricting the flow of oxygenated blood to the heart. Your loved one’s home care arrangements should include the provision of an appropriate healthy diet if they have diabetes as well as regular monitoring of blood sugar levels.

Their carer will be able to ensure that your loved one attends appropriate health care clinics, and carers can help follow any instructions or advice given by health professionals.


Older adults may tend to take less exercise as they age. However, those who do not participate in regular exercise are at an increased risk of developing atherosclerosis. Your loved one should be encouraged to do some physical activity at whatever level is appropriate for them.


Anyone who is obese or overweight is more likely to develop coronary artery disease than those with a healthy BMI (Body Mass Index). A healthy diet is essential, and your loved one may need support to make the right food choices.

Family history

There is evidence that family history plays a part in the risk of developing atherosclerosis. People who have a relative with coronary heart disease who is younger than 55 for a man or 65 for a woman may be at increased risk of developing the condition themselves.


Thrombosis is a blood clot that occurs in a coronary artery can prevent the heart muscle from receiving the blood supply it needs. Thrombosis can potentially lead to a heart attack due to the muscle not having the level of oxygenated blood it requires. Coronary thrombosis is serious and will necessitate admission to a coronary care unit for treatment so that the blood supply to the heart can be restored.

With so many causes of heart diseases, a high level of coronary care must be followed to ensure your loved one or relative can manage the condition in the best way possible, or perhaps even prevent the disease.

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Learn more about complex care

Take a look at more Elder guides on how to support those living with complex conditions below. 

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