Over the last 20 years, there’s been a revolution in treating coronary artery disease (CAD), and scientists make new discoveries every day. By working with your doctor to develop a treatment plan just for you and then sticking to it, you may be able to prevent your CAD from worsening. And it’s possible you could even reverse some of the plaque buildup in your arteries. You can also markedly reduce your risk for a heart attack and look forward to living a long and active life.
The components of your treatment plan may include some combination of the following:
It can be frightening to discover that you have coronary artery disease (CAD). But by making certain lifestyle changes, you can slow the progression of your CAD and help your heart stay strong and healthy for many years to come. While making lifestyle changes is never easy, doing so after a CAD diagnosis is an important part of looking toward the future.
- Stop smoking – It's not easy to stop smoking, but it's essential because smoking is toxic to your heart and blood vessels. Your doctor is a great resource you can use to help you succeed in quitting for good.
- Eat a heart-healthy diet – A diet that is low in fat, cholesterol, salt, and sugar — and with just enough calories to achieve or maintain a healthy body weight — will help you to control your blood pressure, cholesterol levels, blood sugar, and weight. Your doctor may suggest working with a dietician or nutritionist to develop an eating plan.
- Exercise regularly – Studies have shown that you can improve your heart health by exercising at a moderate intensity just 30 minutes a day, five days a week. Be sure to check with your doctor to find out what level of exercise is best for you.
- Manage your stress – Anger, depression, and anxiety have all been linked to heart disease. If you have difficulty with any of these emotions, finding ways to restore your sense of inner peace will not only make you happier, but it will keep your heart and blood vessels healthier.
Several types of medications may be used to treat CAD, depending on your health profile and symptoms, including the following:
- Cholesterol-lowering medications – Statins and other medications are often very effective in lowering blood levels of LDL (the “bad" cholesterol). Other medications may be used to raise levels of HDL (the "good" cholesterol). Together, these two steps can slow or stop plaque buildup in your arteries.
- Beta-blockers – These medications slow your heart rate and reduce the heart's demand for oxygen. Your doctor may prescribe a beta blocker if you have high blood pressure or angina or have had a heart attack.
- Aspirin – By warding off blood clots, aspirin can help save your life during a heart attack. If you've already had a heart attack, taking a low-dose aspirin daily can help prevent another heart attack. While aspirin can lower the risk of a first heart attack, it can also increase the risk of bleeding. The decision to start an aspirin regimen should be discussed with your doctor.
- Angiotensin-converting enzyme (ACE) inhibitors – These medications are used to treat high blood pressure. In addition, if you've had a heart attack, taking an ACE inhibitor can prevent another heart attack.
- Calcium channel blockers – These medications relax blood vessels, which reduces high blood pressure and lightens your heart's workload as it pumps blood throughout your body. Some types of calcium channel blockers also slow the heart rate. A lighter workload means your heart muscle needs less oxygen-rich blood and reduces the likelihood that you'll develop chest pain.
- Nitroglycerin – Nitroglycerin and other nitrates cause your arteries and veins to relax. This lightens your heart's workload by reducing the pressure your heart has to pump against. If you have CAD and have been experiencing angina, your doctor may advise you to carry nitroglycerin tablets or spray with you at all times. Dissolving a nitroglycerin tablet under your tongue or between your cheek and gums can quickly relieve chest pain. Some people with CAD also use longer-acting nitrates to prevent angina from developing.
If a blockage or plaque is severe enough, your doctor may recommend treating it with a minimally invasive procedure such as angioplasty and stenting. With this treatment, an interventional cardiologist expands your obstructed artery by positioning a slender catheter inside, right where your artery is narrowed. Then, a small balloon mounted on the catheter's tip is inflated to create cracks in the plaque and stretch your artery. Next, an expandable mesh metal tube (a stent) is placed inside your artery to act as scaffolding to hold your artery open.
Some people with CAD have a widespread plaque in several arteries or a severe narrowing in the main artery that transports blood from the aorta to the heart. In this situation, your doctor may recommend that it’s safer and more effective for you to have coronary artery bypass graft (CABG) surgery, rather than angioplasty and stenting. During bypass surgery, arteries or veins are taken from other parts of your body, such as your chest and the legs, and sewn onto the diseased arteries in your heart, above and below the obstructive plaque. The new arteries and veins serve to detour blood flow around the plaque, keeping blood flowing to your heart muscle.