What to know about treatments for coronary artery disease

Coronary artery disease (otherwise known as CAD) is the most common type of heart disease in the United States and the leading cause of death among American men and women.

Characterized by a buildup of fatty deposits called cholesterol plaque in the arteries, CAD gradually reduces and impairs blood flow to the heart. When the heart doesn’t receive adequate blood supply, you can experience a range of health problems—from discomfort and tightness in the chest, to difficulty breathing, to abnormal heart beat, to a heart attack.

A number of risk factors contribute to the development of coronary artery disease. These include genetics, obesity, high blood pressure, high cholesterol (a type of fat in the blood), diabetes (high blood sugar levels), and aging—men over age 45 and women over 55 are at an increased risk of developing CAD.

Some lifestyle habits can contribute to the development of CAD, as well:

• Tobacco and excessive alcohol use
• Inactivity and lack of exercise
• An unhealthy diet
• Chronic stress

Your doctor or cardiologist will use specialized tests along with a health history interview to determine whether or not you have CAD. After asking a few questions about your personal health history and family history, a healthcare provider may check your blood pressure, cholesterol, and blood sugar levels and administer tests to get a better idea of your heart’s condition.

If you have coronary artery disease, it’s vital to take control of your condition and improve your heart health now. With the right treatments and lifestyle changes developed with your healthcare team, you can ensure your heart is healthy and pumping efficiently, which can help you avoid serious complications down the road.

Treatments to better manage coronary artery disease

There are many treatments for CAD, including healthy lifestyle changes, prescription medications, and, in serious cases, surgery. Your doctor will determine the best treatment options based on your sex, age, family history, lifestyle habits and the severity of your condition.

Healthier lifestyle habits. Small changes can have a major impact when it comes to heart health. In addition to managing stress, cutting back on alcohol consumption and avoiding saturated (fats that are solid at room temperature) and trans fats (commonly found in processed and junk foods), your doctor may recommend:

• Quitting smoking: smoking is linked to a number of health concerns—and quitting can seriously improve your heart health. But how much of an impact does it really have? Within 20 minutes of quitting, your heart rate and blood pressure will drop. Within 2 to 12 weeks, your circulation will improve. And within 15 years of completely quitting, your risk of CAD drops back to that of a non-smoker’s. While quitting smoking is essential, it’s also important to limit exposure to secondhand smoke as much as possible.
• Eating a wholesome, balanced diet: A diet rich in fruits, vegetables, whole grains, lean proteins like chicken, turkey and beans, and omega-3 fatty acids (found in plant oils like canola oil, nuts, seeds and fish) can improve your heart health and help you maintain a healthier weight.
• Losing weight: Being overweight can raise your levels of “bad” LDL cholesterol and lower your levels of “good” HDL cholesterol, but losing 10 percent of your body weight can improve those numbers. People who are overweight or obese can also reduce their triglycerides (a type of fat in the blood) and blood sugar levels by losing only 3 to 5 percent of their weight. If you weigh 200 pounds, losing 10 percent of your body weight equates to losing 20 pounds, and losing 3 to 5 percent equates to losing 6 to 10 pounds.
• Getting more physical activity: Regular exercise is linked to lower weight, improved blood pressure and cholesterol levels, enhanced mood, and reduced risk of type 2 diabetes (high blood sugar levels). As you are able, aim for at least two hours and 30 minutes of moderate intensity exercise like walking fast or dancing, or one hour and 15 minutes of vigorous intensity exercise like jogging or running each week.

Certain prescription medications. Depending on the degree of blockage in your arteries, your doctor or cardiologist (a doctor who specializes in heart conditions) may recommend prescription medications, in addition to healthy lifestyle habits, to reduce the effects of CAD. The medications you may be prescribed for CAD are designed to:

• Reduce or reverse the buildup of cholesterol plaque in the arteries: Medications called statins, ezetimibe, and PCSK9 inhibitors can lower cholesterol levels, and are commonly prescribed to help manage CAD.
• Ease uncomfortable symptoms: Pain and tightness in the chest are common symptoms of CAD, but many prescription medications can offer relief. Medications that treat chest pain are called antiaginal therapies, and they generally comprise three classes of drugs: Beta blockers reduce the heart’s rate and its contractions and have been proven to prevent subsequent heart attacks. Calcium channel blockers widen, or dilate, blood vessels and reduce the strength of the heart’s contractions. Nitrates can also dilate the blood vessels and alleviate the pain and discomfort associated with CAD. Your doctor may recommend using a combination of these therapies, as well.
• Prevent complications: If you have other conditions that are linked to CAD (also known as comorbidities), your doctor may recommend medications that reduce blood pressure, prevent blood clots, or delay the need for surgery to treat CAD. Some medications that are commonly prescribed to treat comorbidities include blood vessel dilating agents that relax the blood vessels to improve the heart’s muscle function, beta blockers, and blood thinner medications that prevent blood clots, such as aspirin or clopidogrel.

Heart Surgeries. More severe cases of coronary artery disease may require medical procedures or surgeries to treat the blocked arteries. Some procedures used to treat CAD include:

• Percutaneous coronary intervention (PCI): Also known as a balloon angioplasty, this is a nonsurgical procedure that widens blocked arteries. During the procedure, doctors thread a small, flexible tube with a balloon at the end through the arteries, then inflate the balloon to open up the artery. In many cases, a stent (a small mesh tube) is also inserted into the artery to prevent future blockages.
• Coronary artery bypass grafting (CABG): The most common open-heart surgery in the U.S., CABG uses arteries and veins from other parts of the body to bypass narrowed or blocked coronary arteries. This surgery is generally reserved for people with severe coronary artery disease and those who don’t benefit from lifestyle changes and medication alone.

Your healthcare provider may recommend cardiac rehabilitation, as well. During these rehabilitation sessions, you’ll learn heart-healthy habits, how to reduce your risk of cardiac events and ways to exercise safely.

Coronary artery disease is a serious health concern, but with proper treatment and lifestyle changes, it is possible for people with CAD to live full, productive lives.