Treatment and Prevention
Your doctor may prescribe any of these medication treatments:
- Cholesterol-lowering medications can reduce the levels of "bad" (LDL) cholesterol in your blood while increasing the levels of "good" (HDL) cholesterol. Your medication will be chosen based on the amounts of various cholesterol types found in your blood.
- Blood pressure reducing agents can lower your risk of heart attack dramatically if you have high blood pressure. These medications come in several types, and your doctor will advise which medication is best for you.
- Antiplatelet medications prevent clots from forming. Aspirin reduces the chances of having a heart attack. Only small doses (low-dose aspirin) are needed to help prevent a heart attack. If you cannot take aspirin, your doctor may recommend other antiplatelet medications.
- Beta-blockers, calcium channel blockers, and nitroglycerin-type medications are the three main classes of medications used to treat stable angina over time. Medications that treat angina help reduce the heart's workload.
When aggressive treatment is required, your doctor may recommend a procedure to help improve blood flow. Some options include:
- Percutaneous coronary intervention. This is also known as an angioplasty with stent. In this non-surgical procedure, your doctor uses a thin tube (catheter) to place a mesh tube, or stent, in the narrowed artery. The stent keeps the blood vessel open to allow blood to flow. Some stents also release medication that keeps the artery from narrowing.
- Coronary artery bypass surgery. This procedure involves using a blood vessel from another part of the body to create a "bypass" or detour around the blocked or narrowed coronary arteries. Because this requires open heart surgery, this procedure is usually for people who have many blocked arteries or whose blocked arteries are in a place that's difficult to place a stent.
Getting medication treatment isn't the only way to combat coronary artery disease. Here are a few heart-healthy tips to help prevent CAD:
- Quit smoking. If you smoke, quitting is the most important step you can take to quickly and significantly reduce your risk of developing CAD.
- Eat a healthy diet. It should be low in salt and fat (less than 30% of total calories) and high in fiber, fresh fruits, legumes (beans), nuts, and seeds. Avoid saturated fat, partially hydrogenated vegetable oils (also known as trans fat), fried foods, and refined carbohydrates. Losing weight can also offset the risks associated with CAD.
- Drink alcohol moderately. Have no more than 2 drinks per day to a maximum of 9 per week for women or 14 per week for men.
- Get your blood sugar under control. Diabetes increases the risk of CAD, especially if blood sugar levels are not properly controlled. Make sure you are monitoring your blood sugar levels every day and following your diabetes treatment plan.
- Have your cholesterol levels checked regularly. People with diabetes should have this done every 1 to 3 years. Men at least 40 years old and women who are at least 50 years old or postmenopausal should have their cholesterol levels monitored regularly if they do not have CAD or a history of high cholesterol. Adults of any age should get their cholesterol levels checked if they have certain risk factors for heart disease (e.g., high blood pressure, diabetes, family history of CAD, or conditions that increase their risk such as arthritis). Depending on your risk for heart disease, your target cholesterol levels will differ.
- Get regular exercise. Along with reducing the chances of having a heart attack, regular physical activity lowers the heart rate, improves cholesterol levels, and helps control high blood pressure. It can also help you lose weight. Consult your doctor before starting an exercise program, especially if you have any other medical conditions.
- Manage your stress levels. This will also benefit those with high blood pressure. As well, it reduces the levels of some hormones that may increase the risk of having a heart attack.
Glenn Gandelman, MD, MPH, FACC Assistant Clinical Professor of Medicine at New York Medical College, and in private practice specializing in cardiovascular disease in Greenwich, CT. Review provided by VeriMed Healthcare Network.