Coronary Heart Disease Research

The NHLBI supports a wide range of long-term studies on coronary heart disease risk factors. These studies, among others, have led to many discoveries that have increased our understanding of the causes of cardiovascular disease among different populations, helping to shape evidence-based clinical practice guidelines.

• Risk factors that can be changed: The NHLBI Framingham Heart Study (FHS) found that heart disease is caused by risk factors such as smoking, high blood pressure, obesity, high cholesterol levels, and physical inactivity. Researchers also showed that cardiovascular disease can affect people differently depending on sex or race and ethnicity, underscoring the need to address health disparities.
• Risk factors for Hispanic/Latino adults: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) found that Hispanic/Latina women with a history of high blood pressure during pregnancy are at higher risk of changes in heart structure and function decades later, compared with women without a history of high blood pressure during pregnancy. Researchers also used HCHS/SOL genetic data to explore genes linked with central adiposity (having excess body fat around the waist) in Hispanic/Latino adults. Some of the genes identified were more common among people with Mexican or Central/South American ancestry, while others were more common among people of Caribbean ancestry.
• Risk factors for African American people: The Jackson Heart Study (JHS), launched in 1997, includes more than 5,300 African American men and women in Jackson, Mississippi. The goal of the study is to investigate genetic and environmental factors that raise the risk of heart problems, especially high blood pressure, coronary heart disease, heart failure, stroke, and peripheral artery disease. Researchers discovered a gene variant in African American people that doubles their risk of heart disease. A community engagement aspect of the JHS is putting the study's 20-year findings into action by turning traditional gathering places, such as barbershops and churches, into health information hubs.
• Risk factors for American Indian people: The NHLBI actively supports the Strong Heart Study (SHS), the largest and longest-running epidemiologic study of cardiovascular disease and its risk factors among American Indian people. The study began in 1988. In 2024, SHS scientists reported that more than half of the 1,400 American Indian teens and young adults in the study had high levels of cholesterol and fat in their blood. These high levels increase their risk of developing cardiovascular disease. SHS involves a partnership with 12 Tribal Nations and has followed more than 8,000 participants, many of whom live in low-income rural areas of Arizona, Oklahoma, and North and South Dakota.

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The Division of Cardiovascular Sciences' Atherothrombosis and Coronary Artery Disease Branch of its Adult and Pediatric Cardiac Research Program, along with the Center for Translation Research and Implementation Science, oversee much of NHLBI-funded research on coronary heart disease.

Current research on preventing coronary heart disease

• Blood cholesterol and coronary heart disease: The NHLBI supports new research on lowering the risk of coronary heart disease by reducing levels of cholesterol in the blood. Proteins that circulate in the blood, called triglyceride-rich apolipoprotein B-containing lipoproteins (ApoBCLs), can pose a risk/can increase the risk of coronary heart disease. Researchers are working to find innovative ways to reduce the levels of ApoBCLs, which may help prevent coronary heart disease and other cardiovascular conditions.
• Community-level efforts to lower heart disease risk among African American people: The NHLBI is funding initiatives to partner with churches in order to engage with African American communities and lower disparities in heart health. Studies have found that church-led interventions reduce risk factors for coronary heart disease and other cardiovascular conditions. NHLBI-supported researchers assessed data from more than 17,000 participants across multiple studies and determined that these community-based approaches are effective in lowering heart disease risk factors.
• Visiting high-risk mothers in rural America: Obesity and tobacco use are common in the Northern Appalachia region and are risk factors for heart disease. The NHLBI is funding a program to test home visits as a way to engage women who are pregnant, and to help new mothers prevent heart disease by teaching them about healthy lifestyle habits and parenting practices. The study is part of the NHLBI's Early Intervention to Promote Cardiovascular Health of Mothers and Children (ENRICH) program.

Find more NHLBI-funded studies on preventing coronary heart disease on the NIH RePORTER.

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Current research on understanding the causes of coronary heart disease

• Pregnancy and long-term heart disease: NHLBI researchers are continuing the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) to understand the relationship between pregnancy-related problems, such as gestational hypertension, and heart problems. The study also looks at how problems during pregnancy may increase risk factors for heart disease later in life. nuMoM2b researchers found that, at the time women conceived their children, women who had a heart-healthy diet rich in vegetables, fruits, beans, nuts, and seeds were less likely to experience adverse outcomes, such as gestational diabetes or preeclampsia, during their pregnancy. nuMoM2b launched in 2010 and long-term studies are ongoing. The goal is to collect high-quality data and understand how heart disease develops in women after pregnancy.
• International collaboration: The NHLBI supports research to increase our understanding of heart disease in South Asian populations. Even at young ages, and without having traditional risk factors such as overweight, South Asian people are at high risk of coronary heart disease. Since 2010, Indian and U.S. researchers have collaborated to learn more about why this is. Working with some of the 21,864 people who previously joined the study in India, the researchers will collect new data to understand how factors such as stress, sleep, or activity levels affect participants' heart health.
• Genetic predisposition to heart disease: The U.S. Hispanic and Latino population has a relatively high burden of risk factors for cardiovascular disease, including obesity, high blood pressure, and diabetes. NHLBI researchers are doing a thorough genetic analysis to help understand gene patterns related to coronary heart disease and stroke in Hispanic and Latino communities.

Find more NHLBI-funded studies on the causes of coronary heart disease on the NIH RePORTER.

Current research on treatments for coronary heart disease

• Insight into new molecular targets for treatment: NHLBI-supported researchers are investigating the role of high-density lipoprotein (HDL) cholesterol in coronary heart disease and other medical conditions. Understanding how the molecular pathways of cholesterol affect the disease mechanism for atherosclerosis and plaque buildup in blood vessels of the heart can lead to new therapeutic approaches for the treatment of coronary heart disease. Researchers have found evidence that treatments that boost HDL function can lower systemic inflammation and slow down plaque buildup. This could be targeted to develop a new treatment approach for coronary heart disease.
• Long-term studies of treatment effectiveness: The NHLBI is supporting the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial EXTENDed Follow-up (EXTEND), which compares the long-term outcomes of an initial invasive treatment strategy to a more conservative treatment for surviving participants of the original ISCHEMIA study. The aim is to develop a more accurate heart disease risk score to help healthcare providers deliver individualized care for their patients. After checking in with participants periodically, ISCHEMIA-EXTEND researchers reported fewer cardiac deaths among those who had had the initial invasive treatment. However, the number of deaths due to any cause was similar in both groups. Final study results are expected in 2025, after an average of 10 years of follow-up.
• Impact of mental health on response to treatment: NHLBI-supported researchers are investigating how mental health conditions can affect the effectiveness of treatment for people with coronary heart disease. Studies show that depression is linked to a higher risk of negative outcomes related to coronary heart disease. Researchers found that having depression is associated with poor adherence to medical treatment for coronary heart disease. This means that people with depression are less likely to follow through with their heart disease treatment plans, possibly contributing to their likelihood of experiencing worse outcomes. Researchers are also studying new ways to treat depression in patients with coronary heart disease.

Find more NHLBI-funded studies on treating coronary heart disease on the NIH RePORTER.

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• Researchers from the Cardiovascular Branch of the Division of Intramural Research are working to understand the causes and risk factors for cardiovascular diseases and improve diagnostic and treatment options. Specific projects aim to answer clinically relevant questions using methods ranging from molecular-level studies to clinical projects in diagnostics, therapeutics, and interventions.
  • Laboratory of Cardiac Physiology
  • Lipoprotein Metabolism Laboratory
  • Cardiovascular CT Program
  • Laboratory of Cardiovascular Intervention
  • Laboratory of Imaging Technology Program
  • Laboratory of Obesity and Metabolic Diseases
  • Social Determinants of Obesity and Cardiovascular Risk Laboratory
• The Population Sciences Branch explores the prevention and treatment of cardiovascular diseases. Researchers in this branch explore heart, lung, blood, and sleep disorders, using data from thousands of participants in the Framingham Heart Study and other population cohorts. The branch takes a comprehensive approach to understanding these disorders, combining classical epidemiology and longitudinal studies with state-of-the-art genetic and omics technologies.
  • Laboratory for Cardiovascular Epidemiology and Genomics
  • Laboratory for Hemostasis and Platelet Biology
• The Epidemiology and Community Health Branch develops new approaches to study how heart, lung, blood, and sleep disorders affect different populations.
  • Laboratory of Heart Disease Phenomics
  • Laboratory of Genomic Instability and Cardiopulmonary Outcomes
  • Minority Health and Health Disparities Population Laboratory

• In 2002, the NHLBI launched The Heart Truth^®, the first federally sponsored national health education program designed to raise awareness about heart disease as the leading cause of death in women. The NHLBI and The Heart Truth^® supported the creation of the Red Dress^® as the national symbol for awareness about women and heart disease, and they coordinate National Wear Red Day^® and American Heart Month each February.
• The Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) offers qualified investigators access to NHLBI biospecimen and data collections. The main goal is to promote the use of these scientific resources by the broader research community. BioLINCC coordinates searches across data and biospecimen collections and provides an electronic means for requesting additional information and submitting requests for collections. Researchers wishing to submit biospecimen collections to the NHLBI biorepository may also use the website to initiate the application process.
• The NHLBI's Trans-Omics for Precision Medicine (TOPMed) Program studies how genetic information, along with information about health status, lifestyle, and the environment, can be used to predict the best ways to prevent and treat heart, lung, blood, and sleep disorders. TOPMed specifically supports the NHLBI's Precision Medicine Activities.
• The NHLBI's population and epidemiology studies of different groups of people, including the Atherosclerosis Risk in Communities (ARIC) Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study, have made major contributions to understanding what causes and prevents heart and vascular diseases, including coronary heart disease.
• The Cardiothoracic Surgical Trials Network is an international clinical research enterprise that studies heart valve diseases, arrhythmias, heart failure, coronary heart disease, and surgical complications. The trials span all phases of development, from early translation to completion, and have more than 14,000 participants. The trials include six completed randomized clinical trials, three large observational studies, and many other smaller studies.

FACT SHEET

The Truth About Women and Heart Disease Fact Sheet

Learn how heart disease may be different for women than for men.

View the fact sheet