What best describes the primary cause of coronary artery disease (CAD)?

The primary cause of coronary artery disease (CAD) is characterized by a buildup of plaque inside the coronary arteries. This process, known as atherosclerosis, involves the accumulation of fatty deposits, cholesterol, calcium, and other cellular substances within the arterial walls. Over time, this plaque can narrow the arteries, reducing blood flow to the heart muscle, and potentially leading to chest pain (angina) or heart attacks.

The buildup of plaque is influenced by several risk factors including high cholesterol levels, hypertension, smoking, diabetes, and a sedentary lifestyle. As the condition progresses, the plaque can harden and form fibrous tissue, further narrowing the artery and making it less flexible. In some instances, plaques may rupture, leading to a clot that can severely obstruct blood flow and cause acute cardiovascular events. Therefore, the accumulation of plaque is a fundamental and primary mechanism underlying the development of CAD.