Coronary Heart Disease

Published: June 16, 2016
Last reviewed: October 6, 2016

What is coronary heart disease (CHD)?

Coronary heart disease (CHD) refers to the narrowing of the coronary arteries in the heart due to the buildup of plaques in them. CHD can decrease the blood and thus oxygen and nutrients supply to the heart (ischemia), which can result in chest pain (angina pectoris) or heart attack.

Synonyms: coronary artery disease, ischemic heart disease

What are the coronary arteries?

Coronary arteries (from the Latin corona = crown or circle) are 2 arteries that originate from the aorta, run around the heart and supply the heart muscle with blood.

Causes and Risk Factors for CHD

The underlying condition in CHD is the hardening and narrowing (atherosclerosis) of the coronary arteries because of the buildup of plaques composed of cholesterol and calcium (atheroma) in them.

Main controllable risk factors for CHD [1,2]:

  • High LDL and low HDL cholesterol and high triglyceride levels
  • Diabetes mellitus and prediabetes
  • Overweight and obesity
  • High blood pressure
  • Cigarette smoking
  • Lack of physical activity
  • Psychological stress and depression

A particular bad combination of risk factors for CHD, called metabolic syndrome, includes abdominal obesity, high blood pressure, high glucose and triglyceride and low HDL levels [2].

Main non-controllable risk factors for CHD [1,2]:

  • Age >45 in men and >55 in women
  • Genetic predisposition (family history of early CHD, race: African Americans, South Asians)

Other possible risk factors [2]:

  • High levels of small dense LDL particles, homocysteine [77,78] and fibrinogen, and low testosterone levels
  • Chronic inflammatory disease, such as systemic lupus erythematosus or rheumatoid arthritis [51]
  • Too little or too much sleep
  • “Screen time entertainment” (TV, computer, cinema)
  • Vitamin D deficiency [84]
  • End stage kidney disease

There is conflicting evidence about high levels of C-reactive protein (CRP) [2,79,80,81] and lipoprotein(a) [82,83] as independent risk factors for CHD.

Symptoms of CHD

Coronary heart disease, especially in its early phase, can be completely without symptoms. Symptoms appear when the arterial plaques obstruct the delivery of blood and thus nutrients and oxygen to the heart. Initially the pain appears only when the heart needs more oxygen, that is during exercise, but later also during rest.

Individuals with CHD can experience recurrent chest pain called angina pectoris. A complete or prolonged blockage of the coronary arteries can cause death of a part of the heart muscle, called myocardial infarct or heart attack.

Heart related arm pain

Picture 1. Pain distribution in coronary heart disease
(angina pectoris or heart attack)


  • Squeezing pain behind the sternum triggered by exercise, big meal, psychological stress or cold often radiates to the left shoulder blade, neck, jaw and down the inner side of the left arm all the way to the fingers. In women, pain often radiates into both or between the shoulder blades and both arms.
  • In angina pectoris, pain lasts less than 5 minutes and is quickly and completely relieved by rest or nitroglycerin.
  • In heart attack, pain usually lasts more than 15 minutes, can be very severe and is not relieved by rest or nitroglycerin.
  • Other symptoms can include nausea, vomiting and fainting.

Diagnosis of CHD

A doctor can suspect coronary heart disease in a person with recurrent chest pain triggered by exercise.

The following investigations can reveal plaques in the coronary arteries [2,3]:

  • Coronary angiogram or cardiac catheterization (an X-ray image of the coronary arteries after injecting a contrast substance into them)
  • CT angiography
  • Electron-beam computed tomography (EBCT)
  • Carotid intima-media thickness (CIMT) test by using the ultrasound
  • Stress testing (monitoring your heart rhythm and rate, blood pressure, chest pain, shortness of breath during exercise)

Differential Diagnosis

Conditions that can mimic coronary heart disease:

Treatment of CHD

Currently, coronary heart disease cannot be cured, but it can be treated.

1. Drugs

Various combinations of drugs can be used in CHD:

  • To reduce acute pain (angina pectoris): sublingual nitroglycerin (to apply under the tongue)
  • To prevent pain by dilating coronary arteries and reducing oxygen demand by the heart: nitrates (isosorbide), beta-blockers (propranolol), calcium channel blockers (diltiazem, verapamil)
  • To lower high LDL cholesterol: statins (lovastatin) [76]
  • To raise low HDL cholesterol: niacin, fibrates (fenofibrate)
  • To reduce blood clotting in the coronary arteries: aspirin or clopidogrel
  • To lower high blood pressure:
    • Angiotensin-converting enzyme (ACE) inhibitors, such as ramipril (They reduce the risk of complications of CHD, such as heart attack and death, even in individuals with normal blood pressure.) [75]
    • Beta blockers can slow down the progression of the coronary heart disease [110].
  • Ranolazine (anti-ischemic agent) can be used when other drugs are not effective [105].
  • Reference: [75]

2. Supplements and Herbs

There is INSUFFICIENT EVIDENCE about the effectiveness of traditional Chinese herbal medicine in treatment of heart-related chest pain (angina pectoris) [107].

3. Surgery

Balloon angioplasty is a method of widening of narrowed coronary arteries by the catheter that has an inflatable balloon and stent on the end. A doctor inserts the catheter through the femoral artery in the groin and push it toward the heart. When the part of the catheter with the balloon and stent reaches the coronary arteries (which is checked by an X-ray), a doctor inflates the balloon and expands the stent. Then a doctor removes the catheter and the balloon but the stent remains permanently in the artery and keeps it dilated [4]. This method is suitable when only one or few short parts of the arteries are narrowed.

Coronary Artery Bypass Grafting (CABG) is a method of overcoming the narrowed parts of the coronary arteries by using a piece of an artery or vein (usually taken from a patient’s leg, arm or chest) and sewing it with one end in the aorta and the other end in the coronary artery after the narrowing, which enables the blood flow around the narrowing [4]. Bypass is usually done only in severely narrowed coronary arteries; more than one bypass can be done at the same time. Surgery usually results in immediate and complete pain relief [103]. Arterial grafts remain open longer than venous grafts [103]. 20-30% of the patients may need a second procedure within 10 years [104].

Prevention of CHD

What you can do to reduce the risk of coronary heart disease:

  1. Maintain a healthy body weight.
  2. Maintain normal glucose, cholesterol and triglyceride levels.
  3. Maintain normal blood pressure.
  4. Do not smoke and drink excessive amounts of alcohol.
  5. Be regularly physically active.
  6. Learn to cope with emotional stress.

1. Diet

In short:

  • Maintain healthy body weight — this is probably the single most effective dietary approach to decrease the risk of CHD.
  • There is no single nutrient, dietary supplement or food that would prevent CHD. Vegetarian and Mediterranean diet have been associated with decreased risk of CHD in some studies.

Evidence about the HARMFUL effects of nutrients/foods on CHD:

Trans fat. High consumption of trans fats from fast foods (French fries, cheeseburgers, chicken nuggets), commercially baked products (biscuits, crackers, doughnuts, pies), stick margarines, vegetable shortening, coffee creamers, other foods with added “partially hydrogenated oil” or Vanaspati ghee (clarified butter used in South Asia) have been associated with increased risk of CHD [5,6,7,8,9,23].

Saturated fat. According to some systematic reviews of studies, there is a strong association between high intake of saturated fat and CHD [10,11,12], but according to other reviews there is insufficient evidence about such association [13,14,15,16,17,23]. High consumption of processed meat [85] was associated with increased risk of CHD, but consumption of unprocessed red meat (beef, pork, lamb) [85], dairy products [86] and specifically milk [87,88,89], cheese [87] or butter [87] and coconut oil [90,91] was not. Some researchers have suggested that preservatives in processed meat, such as sodium, nitrites, nitrates and nitrosamines, may increase the risk of CHD [85].

Sodium. There is CONFLICTING EVIDENCE about high sodium intake as a risk factor for CHD [18,19,20,21,97]. According to one review, high sodium intake is associated with increased risk of CHD only in individuals with hypertension [22].

There is NO CONVINCING EVIDENCE that high cholesterol (eggs, shrimps, organ meats) [47,48,49,50] total fat [52,53,54] added sugars (soft drinks, sweets) [102] or, specifically, fructose [43] intake would increase the risk of CHD. NOTE: High sugar and fat intake often leads to obesity, which is a risk factor for CHD.

Evidence about the PREVENTATIVE effects of nutrients, supplements or herbs on CHD:

Fish. There is SOME EVIDENCE that consumption of fatty fish high in omega-3 polyunsaturated fatty acids EPA and DHA (mackerel, salmon, sardines, halibut, trout), at least once to twice weekly [35], but less likely fish oil supplements [35,37,109,111] decreases the risk of CHD. NOTE: Fish oil may decrease the risk of CHD only in people with known risk factors (obesity, high LDL cholesterol and triglycerides) [37]. In people who regularly consume fish, fish oil probably does not have any additional heart-protecting effect [37].

There is SOME EVIDENCE that replacing some of saturated fats with polyunsaturated fats in the diet can reduce the risk of CHD [38,39,40,41].

Whole grains. There is SOME EVIDENCE that regular intake of insoluble dietary fiber from whole-grain cereals and vegetables [55], beta-glucan from whole barley and oats [56,108] or psyllium husk (at least 7 g/day) [57] is associated with the lower risk of CHD.

Vegetarian and Mediterranean diet. According to 3 reviews of observational studies, vegetarians had 25-34% lower mortality from ischemic heart disease than regular meat eaters [63,64,65]. Mediterranean diet (regular consumption of whole grains, fish, poultry, vegetables, beans, potatoes, fruits, olive oil, nuts, seeds and wine) was also associated with lower risk of CHD [66,67,68,69,70].

Moderate alcohol drinking (up to 2 drinks per day for men and 1 drink per day for women) was associated with decreased risk of CHD when compared with excessive drinking or not drinking at all [28,29,30]. There is not enough evidence to claim that red wine (high in polyphenols) is more effective in prevention of CHD than other alcoholic beverages [27].

There is INSUFFICIENT EVIDENCE about the preventative effect of high intake or supplementation of any nutrient or herb, such as coenzyme Q10 [31], antioxidants or vitamins A, C, D, E [45], B6, B12 or folate [44], choline [46], flavanols in green or black tea [32], soy isoflavones [36], resveratrol [33], garlic [96], phytosterols [97,98], alpha-linolenic acid from flaxseed oil [34], potassium [60], calcium [59], magnesium [58], chocolate or cocoa (high in polyphenols [100,101], Tong-xin-luo capsules [106] or monounsaturated fatty acids from olive oil or nuts [40,42] on CHD.

There is INSUFFICIENT EVIDENCE about the preventative effect of a low-carb [71,72] or low glycemic index diet [62] on CHD.

2. Exercise

There is SOME EVIDENCE that regular physical exercise (at least 30 min/day) may decrease the risk of CHD [92], possibly because it helps to maintain health body weight, increase HDL and decreased LDL cholesterol and triglyceride levels [93,95] and decreases the risk of diabetes 2 (insulin resistance) [94].

There is INSUFFICIENT EVIDENCE about the preventative effect of yoga on CHD [61].

3. Drugs

Aspirin, taken regularly, can modestly decrease the risk of CHD [73,74].

Caffeine does not seem to decrease or increase the risk of CHD [24,25,26].

  • References

      1. What Are Coronary Heart Disease Risk Factors?  National Heart, Lung and Blood Institute
      2. Bodi FB, Risk factors for coronary heart disease  Emedicine
      3. How is coronary heart disease diagnosed?  National Heart, Lung and Blood Institute
      4. Michaels AD et al, 2002, Angioplasty Versus Bypass Surgery for Coronary Artery Disease  Circulation
      5. Mozaffarian D et al, 2006, Trans Fatty Acids and Cardiovascular Disease  The New England Journal of Medicine
      6. Teegala SM et al, 2009, Consumption and health effects of trans fatty acids: a review  PubMed
      7. Mente A et al, 2009, A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease  PubMed
      8. Ascherio A et al, 1999, Trans Fatty Acids and Coronary Heart Disease  The New England Journal of Medicine
      9. 2007, Opinion of the Scientific Panel on Dietetic products, nutrition and allergies [NDA] related to the presence of trans fatty acids in foods and the effect on human health of the consumption of trans fatty acids  European Food Safety Authority
      10. What is the effect of saturated fat intake on increased risk of cardiovascular disease or type 2 diabetes?  USDA Nutrition Evidence Library
      11. 2002, Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)  Circulation
      12. Dietary fats: Total Fat and Fatty Acids  US Department of Agriculture
      13. Siri-Tarino PW et al, 2010, Saturated Fatty Acids and Risk of Coronary Heart Disease: Modulation by Replacement Nutrients  PubMed Central
      14. Hooper L et al, 2001, Dietary fat intake and prevention of cardiovascular disease: systematic review  The BMJ
      15. Mente A et al, 2009, A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease  PubMed
      16. Chowdhury R et al, 2014, Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary Risk: A Systematic Review and Meta-analysis  Annals of Internal Medicine
      17. Hoenselaar R, 2011, Saturated fat and cardiovascular disease: The discrepancy between the scientific literature and dietary advice  Nutrition
      18. Sodium  Linus Pauling Institute
      19. Aburto NJ et al, 2013, Effect of lower sodium intake on health: systematic review and meta-analyses  PubMed
      20. Stamler J, INTERSALT study, 1984-1997  University of Minnesota
      21. 2012, Effects of reduced sodium intake on cardiovascular disease, coronary heart disease and stroke  World Health Organization
      22. Joosten MM et al, 2014, Sodium excretion and risk of developing coronary heart disease  PubMed
      23. de Souza RJ et al, 2015, Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies  The BMJ
      24. 2012, Regular, moderate, coffee drinking may reduce heart failure risk
      25. Ding M et al, 2014, Long-Term Coffee Consumption and Risk of Cardiovascular Disease: A Systematic Review and a Dose-Response Meta-Analysis of Prospective Cohort Studies  PubMed
      26. Greenberg JA et al, 2007, Caffeinated beverage intake and the risk of heart disease mortality in the elderly: a prospective analysis The American Journal of Clinical Nutrition
      27. Brien SE et al, 2011, Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies  PubMed Central
      28. Alcoholic beverages  Linus Pauling Institute
      29. Hein HO et al, 1997, Alcohol consumption, S-LDL-cholesterol and risk of ischemic heart disease. 6-year follow-up in The Copenhagen Male Study  PubMed
      30. Mukamal KJ et al, 2003, Alcohol consumption and carotid atherosclerosis in older adults: the Cardiovascular Health Study  PubMed
      31. Coenzyme Q10, evidence  Mayo Clinic
      32. Hartley R et al, 2013, Green and black tea to prevent cardiovascular disease  Cochrane
      33. Sahebkar A et al, 2015, Lack of efficacy of resveratrol on C-reactive protein and selected cardiovascular risk factors–Results from a systematic review and meta-analysis of randomized controlled trials  PubMed
      34. Flaxseed oil  WebMD
      35. Omega-3 supplements: in depth  National Center for Complementary and Integrative Health
      36. Soy WebMD
      37. Kris-Etherton PM et al, 2002, Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease  Circulation
      38. Hooper L et al, 2015, Effect of cutting down on the saturated fat we eat on our risk of heart disease  Cochrane
      39. Mozaffarian D et al, 2010, Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials  PubMed
      40. Siri-Tarino PW et al, 2010, Saturated Fatty Acids and Risk of Coronary Heart Disease: Modulation by Replacement Nutrients  PubMed Central
      41. Jakobsen MU et al, 2009, Major types of dietary fat and risk of coronary heart disease: A pooled analysis of 11 cohort studies
      42. Schwingshackl L et al, 2012, Monounsaturated Fatty Acids and Risk of Cardiovascular Disease: Synopsis of the Evidence Available from Systematic Reviews and Meta-Analyses  PubMed Central
      43. Tappy L et al, 2010, Metabolic Effects of Fructose and the Worldwide Increase in Obesity Physiological Reviews
      44. Myung S-K et al, 2013, Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials  The BMJ
      45. Vitamin E evidence  Mayo Clinic
      46. Choline  WebMD
      47. Kratz M, 2005, Dietary cholesterol, atherosclerosis and coronary heart disease  PubMed
      48. Shin JY et al, 2013, Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis  PubMed Central
      49. Rong Y et al, 2013, Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies  The BMJ
      50. 2010, Eggs and cardiovascular disease, a systematic review  Cancer and Diet
      51. Rheumatoid arthritis, clinical presentation  Emedicine
      52. Schwab U et al, 2014, Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review  PubMed Central
      53. Hooper L et al, 2012, Effect of reducing total fat intake on body weight: systematic review and meta-analysis of randomised controlled trials and cohort studies  PubMed Central
      54. Mente A et al, 2009, A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease  PubMed
      55. Threapleton, DE et al, 2013, Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis  The BMJ
      56. §101.81 Health claims: Soluble fiber from certain foods and risk of coronary heart disease (CHD)  Electronic Code of Federal Regulations
      57. Bernstein AM et al, 2013, Major Cereal Grain Fibers and Psyllium in Relation to Cardiovascular Health  PubMed Central
      58. Magnesium  Linus Pauling Institute
      59. Calcium intake and risk of cardiovascular disease  PubMed
      60. 2012, Potassium intake for adults and children  World Health Organization
      61. Kwong JSW et al, 2015, Yoga for secondary prevention of coronary heart disease  Cochrane
      62. Kelly SAM et al, 2004, Low glycaemic index diets for coronary heart disease  Cochrane
      63. Key TJ et al, 1999, Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies  The American Journal of Clinical Nutrition
      64. Dinu M et al, 2016, Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies  PubMed
      65. Huang T et al, 2012, Cardiovascular disease mortality and cancer incidence in vegetarians: a meta-analysis and systematic review  PubMed
      66. Buckland G et al, 2009, Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study  PubMed
      67. Martínez-González MA et al, 2011, Mediterranean diet and the incidence of cardiovascular disease: a Spanish cohort  PubMed
      68. Mente A et al, 2009, A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease  PubMed
      69. Fidanza F et al, 2004, Mediterranean Adequacy Index: correlation with 25-year mortality from coronary heart disease in the Seven Countries Study  PubMed
      70. Panagiotakos DB et al, 2004, Can a Mediterranean diet moderate the development and clinical progression of coronary heart disease? A systematic review.  PubMed
      71. Naude CE et al, 2014, Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis PubMed
      72. Santos FL et al, 2012, Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors PubMed
      73. Sutcliffe P et al, 2013, Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews  PubMed
      74. Brottons C et al, 2015 et al, A Systematic Review of Aspirin in Primary Prevention: Is It Time for a New Approach?  PubMed Central
      75. Alaeddini J, Angina pectoris treatment & management  Emedicine
      76. Yan YL et al, 2013, Efficacy and safety evaluation of intensive statin therapy in older patients with coronary heart disease: a systematic review and meta-analysis  PubMed
      77. Ganguly P et al, 2015, Role of homocysteine in the development of cardiovascular disease  PubMed Central
      78. Harish RB et al, 2007, Risk prediction—Homocysteine in Coronary Heart Disease  PubMed Central
      79. C Reactive Protein Coronary Heart Disease Genetics Collaboration (CCGC), 2011, Association between C reactive protein and coronary heart disease: mendelian randomisation analysis based on individual participant data  PubMed Central
      80. Shrivastava AK et al, 2015, C-reactive protein, inflammation and coronary heart disease  ScienceDirect
      81. Strang F et al, 2014, C-Reactive Protein and Coronary Heart Disease: All Said—Is Not It?  Hindawi
      82. Jacobson TA, 2013, Lipoprotein(a), cardiovascular disease, and contemporary management  PubMed
      83. Malaguarnera M et al, 2013, Lipoprotein(a) in Cardiovascular Diseases  Hindawi
      84. Siadat ZD et al, 2012, Association of vitamin D deficiency and coronary artery disease with cardiovascular risk factors  PubMed Central
      85. Micha R et al, 2010, Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus: a systematic review and meta-analysis  PubMed Central
      86. 2010, What is the relationship between the intake of milk and milk products and cardiovascular disease?  USDA Nutrition Evidence Library
      87. Huth PJ et al, 2012, Influence of Dairy Product and Milk Fat Consumption on Cardiovascular Disease Risk: A Review of the Evidence  Advances in Nutrition
      88. Mente A et al, 2009, A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease JAMA Internal Medicine
      89. Elwood PC et al, 2010, The Consumption of Milk and Dairy Foods and the Incidence of Vascular Disease and Diabetes: An Overview of the Evidence  PubMed Central
      90. Lipoeto NI et al, 2004, Dietary intake and the risk of coronary heart disease among the coconut-consuming Minangkabau in West Sumatra, Indonesia  PubMed
      91. Palazhy S et al, 2012, Composition of plasma and atheromatous plaque among coronary artery disease subjects consuming coconut oil or sunflower oil as the cooking medium  PubMed
      92. Batty GD et al, 2002, Physical activity and coronary heart disease in older adults. A systematic review of epidemiological studies  PubMed
      93. Mann S et al, 2014, Differential Effects of Aerobic Exercise, Resistance Training and Combined Exercise Modalities on Cholesterol and the Lipid Profile: Review, Synthesis and Recommendations  PubMed Central
      94. Colberg SR et al, 2010, Exercise and Type 2 Diabetes, The American College of Sports Medicine and the American Diabetes Association: joint position statement  PubMed Central
      95. Escalante Y et al, 2012, Improvement of the lipid profile with exercise in obese children: a systematic review  PubMed
      96. Qidwai W et al, 2013, Role of Garlic Usage in Cardiovascular Disease Prevention: An Evidence-Based Approach  PubMed
      97. Genser B et al, 2012, Plant sterols and cardiovascular disease: a systematic review and meta-analysis  PubMed
      98. Gupta AK et al, 2011, Role of phytosterols in lipid-lowering: current perspectives  QJM
      99. 2013, Sodium Intake in Populations: Assessment of Evidence  National Academics
      100. Ding EL, Hutfless SM, Ding X, Girota S, 2006, Chocolate and Prevention of Cardiovascular Disease: A Systematic Review  PubMed
      101. Khawaja O et al, 2011, Chocolate and coronary heart disease: a systematic review  PubMed
      102. Malik VS et al, 2010, Sugar Sweetened Beverages, Obesity, Type 2 Diabetes and Cardiovascular Disease risk  PubMed Central
      103. Aroesti JM, 2016, Patient information: Coronary artery bypass graft surgery (Beyond the Basics)  UpToDate
      104. Coronary artery bypass  Texas Heart Institute
      105. Alaeddini J, Angina pectoris medication  Emedicine
      106. Mao C et al, 2015, Tong-xin-luo capsule for patients with coronary heart disease after percutaneous coronary intervention  Cochrane
      107. Zhuo Q et al, 2010, This review did not find strong evidence to demonstrate the effect of traditional Chinese herbal products in the treatment of stable angina  Cochrane
      108. Kelly SAM et al, 2007, Wholegrain cereals for coronary heart disease  Cochrane
      109. Mohebi-Nejad A et al, 2014, Omega-3 Supplements and Cardiovascular Diseases  PubMed Central
      110. Siphai I et al, 2007, Beta-blockers and progression of coronary atherosclerosis: pooled analysis of 4 intravascular ultrasonography trials  PubMed
      111. Rizos EC et al, 2012, Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis  PubMed

Leave a Reply

Your email address will not be published. Required fields are marked *