PCAD is coronary artery disease that occurs in younger adults. A person can improve their outcomes by following their treatment plan and making changes to their daily habits.

Coronary artery disease (CAD) is the most common type of heart disease in the United States. It occurs when deposits of cholesterol and other substances, collectively known as plaque, build up in the arteries leading to the heart. Over time, plaque buildup can narrow the arteries or block them all together and cause heart failure and heart attack.

Premature coronary artery disease (PCAD) is when a younger person has CAD. People may also refer to this as early-onset CAD or CAD in young adults.

According to a 2021 review, PCAD occurs when males develop CAD before 45 years and females before 55 years. However, the review notes that some studies cite a 45–65 age range.

This article discusses PCAD and its causes, symptoms, treatment, and outlook.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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The symptoms of PCAD are similar to the symptoms of CAD. Often, a person will not know they have CAD or PCAD until they have a heart attack.

Most people with CAD will experience angina at some point. Angina is chest pain or discomfort when too much plaque builds up in the arteries. This can narrow the arteries and disrupt blood flow, leading to chest pain.

The symptoms of PCAD can vary slightly from person to person and in males and females. Females are more likely to experience atypical symptoms, including:

PCAD occurs due to a buildup of plaque in the arteries. This causes the arteries to narrow or harden, reducing or blocking blood flow to the heart.

More than 80% of people with PCAD have modifiable risk factors. These risk factors include:

If a person takes steps to control these risk factors, such as following their treatment plan for diabetes, managing their blood pressure, and quitting smoking, they can lower their risk of PCAD or improve their outcomes.

Other risk factors for PCAD and CAD in general include:

  • age
  • gender
  • ethnicity
  • family history of heart disease
  • certain genetic disorders

There is no cure for PCAD. However, a person can manage PCAD through lifestyle changes, medications, and medical procedures.

A person with PCAD may want to consider making lifestyle changes to reduce preventable risk factors for PCAD. These changes can include:

Doctors may prescribe medications to help lessen the impact of PCAD. Medications may include:

Doctors may recommend that some people with PCAD who have already had a heart attack or stroke take aspirin as a way to prevent future heart attacks. However, the American Heart Association (AHA) notes that people who have not had a heart attack or stroke should not take aspirin as a preventive measure and that people should discuss taking aspirin for heart disease with their doctor because of the risks of doing so.

Some people with CAD may need surgery. Surgical procedures a person with PCAD may need include coronary bypass surgery or angioplasty and stent placement.

In coronary bypass surgery, a surgeon bypasses a blocked artery with a blood vessel from another area of the body.

In angioplasty and stent placement, a surgeon inserts a small tube called a catheter into the narrowed artery and opens it by inflating a balloon to press the plaque against the artery walls. The surgeon will often leave a stent or small tube in the artery to help the artery stay open.

CAD is the leading cause of death worldwide.

In adults over 65 years, the mortality rate has declined in the past 30 years. However, for adults younger than 55, the mortality rate only improved slightly over the past 20 years, decreasing 0.1%.

While PCAD has slightly declined, more people under the age of 65 have at least three major risk factors for PCAD between 2000 and 2016. The increased risk factors translate into increased mortality in younger adults with PCAD.

To improve outcomes, a person with PCAD can make changes to any modifiable risk factor they may have. For example, this means managing blood sugar levels if they have diabetes, controlling blood pressure, maintaining a moderate weight, and quitting smoking if this applies to them.

PCAD is coronary artery disease that occurs in males before the age of 45 or females before 55.

Most people with PCAD have modifiable risk factors such as uncontrolled high blood pressure or diabetes, having obesity, smoking, or living a sedentary lifestyle.

A person can take steps to lower their risk of PCAD or slow its progression by controlling those risk factors.

There is no cure for PCAD, but treatments and lifestyle changes can slow its progression and improve a person’s quality of life.