This document discusses coronary heart disease (CHD), which over 58 million Americans have at least one form of. The major underlying cause of CHD is atherosclerosis, a slow, progressive disease beginning in childhood. Plaque forms in artery walls in response to endothelial injury. Risk factors include age, family history, hypertension, smoking, diabetes, inactivity, obesity, and abnormal blood lipids. Lifestyle changes like a healthy diet, physical activity, and weight control can help lower risk, as well as medications like statins for those with high LDL cholesterol.