Chirag Chauhan, MD on the risk factors for coronary artery disease (CAD)

Chirag Chauhan, MD has guided countless patients through the prevention and treatment of coronary artery disease (CAD) – the most common type of heart disease.

Since starting his first fellowship in 2012, Dr. Chauhan has accumulated more than a decade’s worth of experience in medication and disease management; valvular procedures such as transcatheter aortic valve replacement (TAVR), WATCHMAN and MitraClip; complex interventional procedures like High-Risk PCI (Percutaneous Coronary Intervention) or cardiogenic shock; and medical therapy. Dr. Chauhan - a structural interventional cardiologist - joined Boulder Heart at Boulder Community Health (BCH) in September of 2025.

Fueled by ongoing increases in high blood pressure, obesity and other major risk factors, heart disease continues to kill more people in the United States than any other cause, according to the American Heart Association’s 2025 Heart Disease and Stroke Statistics Update.  

While medical advances have helped more people live longer with cardiovascular diseases, trust between each doctor and patient is still paramount.  

Dr. Chauhan works diligently with his patients to share with them the latest in lifestyle education, clinical studies and guidelines. 

“I think one of the best parts of my job is having patient continuity; I really enjoy that I see patients over the years and get to spend a lot of time providing personalized care,” he says. “I see them through their procedures. I follow them long term. I sometimes even see their kids.” 

Dr. Chauhan’s risk reduction strategy

Coronary artery disease (CAD) affects the main blood vessels that supply blood to the heart, called the coronary arteries. The cause? A buildup of fats, cholesterol and other substances called “plaque” in and on the artery walls. This plaque buildup, which often develops over many years, causes the arteries to narrow and symptoms of fatigue, shortness of breath, and chest pain. As the coronary arteries continue to narrow, these symptoms can become more severe or frequent and ultimately lead to a heart attack.  

For his patients with high cardiovascular risk for coronary artery disease or those with a diagnosis of coronary artery disease by coronary calcium score, these are the risk factors Dr. Chauhan says are important to alleviate or control:  

#1: Diet:

Dr. Chahan advises a mediterranean or plant-based diet, which has been shown to significantly lower cardiovascular disease (CVD) risk by reducing risk factors such as cholesterol, blood pressure and inflammation.  

“Ideally, if you can do a vegan-based diet, that’s going to be the best thing for you,” he says, even though he knows it’s a difficult commitment.  

Taking up a vegan diet or going plant-based will decrease the cholesterol that’s being taken in from outside sources. A human body will still produce some cholesterol, but Dr. Chauhan says it will be much lower and significantly reduce inflammation inside the body.  

“Cholesterol comes from animal biproducts, whether it be dairy, poultry, chicken, fish or red meat,” Dr. Chauhan says. “The problem is that a lot of those things cause inflammation in the vessels, which then leads to higher areas of plaque formation. 

“Inflammation in general causes plaque to build up a lot of places. You can get it in your carotid arteries, in your peripheral vascular [arteries] or in the coronary arteries, and that’s always a concern.”

#2 Exercise:

Thirty minutes of cardio three to five days a week is what Dr. Chauhan suggests. “If not, mix in some strength training too, which is beneficial,” he says.  

During wintertime, Dr. Chauhan advises caution if you choose to shovel snow – a full-body workout, especially to those who haven’t been regularly exercising.  

“One of the most common things we see at Boulder Heart is patients coming in with myocardial infarctions or heart attacks, mostly due to shoveling snow,” Dr. Chauhan says. “If you haven’t been doing any [exercise or movement] for a period over the summer and then go out and shovel your own snow, you’re exerting yourself more than you’re used to, and that can potentially lead to heart attacks. You become unstable.”  

Dr. Chauhan’s recommendation is to be cautious and take your time.  

“Take breaks often, especially in the cold weather, and keep yourself as warm as possible,” he says. “If you’re high risk, especially if you have a history of coronary artery disease or coronary calcium that’s elevated, I would take my time and do it with somebody’s knowledge that you’re going out to shovel snow.” 

#3: Blood pressure:

To ideally achieve a blood pressure reading of 130/80, Dr. Chauhan works with patients to prescribe the best combination of antihypertensives with common types including ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, and diuretics.  

#4: Lipids:

Blood cholesterol levels include a group of fats also known as lipoproteins, or lipids, which include HDL-C, or “’good’ cholesterol” and LDL-C or “’bad’ cholesterol.” 

The European Society of Cardiology (ESC/EAS) guidelines recommend an LDL-C target of less than 55 mg/dL (<1.4 mmol/L) for very high-risk patients (like those with established coronary artery disease/ASCVD). They advocate that "lower is better" to prevent cardiovascular events.  

A high LDL-C level is linked to a higher risk for CVD. A diet high in saturated and trans fats can raise your LDL cholesterol. 

“I believe that the American College of Cardiology (ACC) and American Heart association (AHA) will follow suit and make that recommendation (of less than 55 mg/dL)” says Dr. Chauhan. “We at Boulder Heart are already starting that recommendation because we want to try to prevent worsening progression of coronary artery disease.” 

Even without coronary artery disease, “sometimes genetic makeup just makes someone prone to high cholesterol,” says Dr. Chauhan.  

“Instead of excreting it, they get the calcium to build up in their coronaries, and they can be at risk,” he says.  

The plant-based diet Dr. Chauhan suggests paired with avoiding dairy and poultry, when possible, can also further improve cholesterol control, according to Dr. Chauhan.  

#5: Tobacco, blood glucose and alcohol

Smoking is a major risk factor for coronary artery disease and a known factor influencing the severity and pattern of CAD. Quitting smoking is probably the most important step someone can take to decrease their chances of developing heart disease and having a heart attack. Within one year of quitting smoking, the risk of CAD is about half that of a smoker (Source: World Heart Federation).  

For those with diabetes, higher levels of sugar in the body causes plaque to build up throughout the blood vessels. Prolonged high blood sugar levels (hyperglycemia) lead to chronic inflammation.  

“It’s the same idea as eating a lot of red meat, which just causes more inflammation in the vessels themselves,” says Dr. Chauhan.  

According to Dr. Chauhan, alcohol use can lead to atrial fibrillation (AFib) and poor sleep and has “inherent cardiovascular risk.”  

“I think alcohol in moderation is OK,” he says. “But from a cardiovascular standpoint, I often tell my patients, especially those that have hypertension, that they should be very well aware that alcohol can increase your blood pressure and lead you into atrial fibrillation.”  

Schedule a consultation with Dr. Chauhan

Smoking or having high blood pressure, high cholesterol, diabetes, obesity or a strong family history of heart disease makes you more likely to develop coronary artery disease. 

If you believe you’re at high risk of CAD or would like to undergo testing for narrowed arteries, the Boulder Heart team and Dr. Chauhan are here to help. Schedule a consultation with Dr. Chauhan and call 303-442-2395. 

About Dr. Chauhan

Chirag Chauhan, MD, who joined Boulder Heart earlier this year and trained at renowned Cedars Sinai Medical Center, is BCH’s newest structural interventional cardiologist. With more than two decades of experience, Dr. Chauhan is board-certified in Internal Medicine, Cardiovascular Diseases, Echocardiography, and Interventional Cardiology. He is also a Fellow of both the American College of Cardiology (FACC) and the Society for Cardiovascular Angiography and Interventions (FSCAI). He most recently served as a Structural Interventional Cardiologist at Aurora Denver Cardiology Associates.