Why do people get heart disease? Although this might seem like a very simple question, it isn't really.

The traditional medical answer for why people get heart disease is that people get heart disease (and by this we are talking about cholesterol deposits inside the heart arteries: coronary heart disease) because of risk factors.

They have various risk factors- smoking, high blood pressure, high serum cholesterol, diabetes, obesity, family history of heart disease, low HDl cholesterol, inactivity, or other risk factors and this is the reason that a person is stricken with heart problems.

Although this seems like a good answer, it isn't really the answer. While it is true that people who have risk factors are more likely to get a heart blockage, risk factors aren't the real cause of heart attacks and cholesterol build up inside the arteries.

Medical science doesn't know completely, but our main working theory is that injury to the inner lining of the arteries what is called the Intima (a single row of cells that line the artery) is the real culprit.

When the Intima becomes injured then the natural balance between cholesterol moving into the artery and out of the artery is disturbed. You see cholesterol and many other substances are always moving in and out of cells.

But when the Intima becomes injured it stops working like it should and cholesterol begins to build up in the arteries. Dysfunction of the normal working of the Intima is critical in the formation of heart blockages.

We can consider this injury to be much like the injury to any part of the body.

Think what happens when an irritant is poured on our skin. Say we pour a chemical that causes a burn of the skin. The cells on the outermost part of the skin become red and inflamed. If the injury is bad enough, the outer skin may be penetrated and an actual burn may occur.

Injury to the Intima happens in the same way. Certain substances that may be toxic to the Intima circulate in the blood and injure the one cell thick lining, leading to inflammation.

So the logical question is: What causes injury to the Intima?

Scientists still don't know conclusively but repetitive injury to the Intima is thought to occur from high blood pressure (for most cases of high blood pressure the cause is unknown), an infection in the artery wall, or high levels of LDL cholesterol.

It has also been shown that certain growth factors- chemical messengers, somehow turn on the process of cholesterol buildup. This suggests that the body's immune system may play a role. So the answer to what causes heart blockages is still unclear.

What is known is that what we do to our bodies: what we eat, our lack of exercise, our excessive weight, what we smoke, and having uncontrolled blood pressure predisposes a person to heart disease. But did you know that Stress and even our negative emotions: anger, sadness, fear, anxiety, depression, and loneliness have been shown to actually cause heart disease?

In one study, it was found that people who suffered from Anxiety had twice the likelihood of having a heart attack as people who don't have anxiety.

Luckily, even if we may not know the cause of heart blockages they can be prevented and even reversed. We can begin the process of lowering our chances of etting heart disease by altering our lifestyle choices.

We can choose to eat better, exercise more, stop smoking, and control our blood pressure. We can also choose to heal our sadness, release our anxiety, and overcome the anger that plagues us. Many resources are available for healing. You can check out a Yoga class, begin to meditate, or consider starting therapy.

A technique called practicing remembrance can also be very useful. I teach this technique in my book, "How to Heal Your Broken Heart" www.drlaman.com

Choose what's right for you, but make a choice. It could be the thing that leads you down the road to greater heart health.

Kirk Laman, D.O., F.A.C.C. Heart Specialist * Author * Educator * Healer/Pastor

Dr. Kirk Laman is a board certified cardiologist who helps people struggling with physical, emotional or spiritual heart problems. Dr. Laman practices cardiology with The Thoracic Cardiovascular Institute, Mid-Michigan