September 9th, 2010 | 
Author: I am a 26 year old female with a blood pressure ranging from 116-118/76-78. I have never had hypertension. I am obese, however, with a strong family history of heart disease on my father’s side. I know what I need to do to be healthy, so please – no lectures. My specific question is regarding the likelihood of having coronary artery disease or severe atherosclerosis without any hypertension. Not just applying to me, either, but generally speaking. Thank you.
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What causes CAD is atherosclerosis and what causes atherosclerosis is, aside from hypertension, smoking, lipidemia and high glucose levels or having actual diabetes. Other factors are obesity and inactivity — obesity increases the likelihood of developing lipidemia & hypertension and inactivity increases the risk for heart attack. Of course there are risk factors, called fixed risk factors, that we have no control over. These are gender, family history and age. These have nothing to do with hypertension. The lifetime risk of developing CAD is higher in men than in women at all ages. Being female, you may be relatively protected against CAD but you already have two known risk factors but I can’t tell from what you’ve written if you have more.
In case you’re interested, in women the duration of insulin-dependent diabetes, hypertension, waist-hip ratio, physical activity and depressive symptomatology are all significant independent predictors of CAD.
And even if a person had none of these risk factors, no fixed risk factors, no modifiable risk factors, that person could still develop CAD anyway.
"Can you develop coronary artery disease without hypertension?" — Yes.
Congratulations on your low Bp. Yes you can have artery disease without high Bp. Plague is a result of high cholesterol, high triglycerides, low Hdl’s. Genetics also plays a role here. Age contributes also as we get older the vessels become less pliable. Cholesterol is a needed product in the body, if you don’t get enough of it in your food the body will make it anyway.
Your bodies already demonstrated an excess of something (fat) that will take its toll eventually.
Just because being fat is now the normal doesn’t mean its good for you. I’m a fat nurse, got so when I retired, so I should know better. Its not easy staying trim.
yes, and also see this study http://hyper.ahajournals.org/cgi/content/full/30/5/1279