Question

How is coronary artery disease treated?

Answer 1

Your healthcare provider will talk to you about the best treatment plan for you. Follow your treatment plan to reduce your risk of problems that can result from coronary artery disease, like heart attack and stroke.

Lifestyle changes

The first step in treating coronary artery disease is to reduce your risk factors. This involves making changes in your lifestyle.

• Don’t smoke. If you smoke or use tobacco products, quit. Ask your healthcare providers about ways to quit, including programs and medications.
• Manage health problems like high cholesterol, high blood pressure and diabetes.
• Eat a heart-healthy diet. Talk to your healthcare provider or a registered dietitian about ways to change your diet to reduce your risk of heart disease. Good dietary choices include the Mediterranean and DASH diets.
• Limit alcohol use. Limit daily drinks to no more than one drink per day for women and two drinks per day for men.
• Increase your activity level. Exercise helps you lose weight, improve your physical condition and relieve stress. Most people can reduce their risk of heart attack by doing 30 minutes of walking five times per week or walking 10,000 steps per day. Talk to your healthcare provider before you start any exercise program.

Medications

Your healthcare provider will recommend medications to best manage your risk factors for heart disease. Types of heart-related medications that may be selected for you include:

• Medication to lower your cholesterol levels, such as statins, bile acid sequestrants, niacin and fibrates.
• Medications to lower blood pressure, such as beta blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers.
• Medications to stop angina, such as nitrates/nitroglycerin or ranolazine.
• Medications to reduce the risk of blood clots, such as anticoagulants (including aspirin) and antiplatelets.

If you have diabetes and coronary artery disease, you’ll be prescribed medications to lower your blood sugar level.

It's important to take all medications as prescribed, including those for heart disease and all other health conditions. Talk to your healthcare provider if you have any questions or concerns about which medications to take or how to take them.

Procedures and surgery

Interventional procedures are nonsurgical treatments to get rid of plaque buildup in the arteries and prevent blockages. Common procedures are balloon angioplasty and stenting. These procedures are done with a long, thin tube called a catheter. It is inserted into an artery in the wrist or the top of the leg through a small incision and guided to the blocked or narrowed area of the artery. The balloon widens the diameter of the artery to restore blood flow to the heart. A stent (a small metal spring-like scaffold) is left in place to keep your artery open.

Coronary artery bypass graft (CABG) surgery involves creating a new path for blood to flow when there is a blockage in the coronary arteries. In most cases, the surgeon removes blood vessels from your chest, arm or leg, and creates a new pathway to deliver oxygen-rich blood to the heart.

If traditional treatment options are not successful, your cardiologist may recommend other treatment options, such as enhanced external counterpulsation (EECP). In this procedure, inflatable cuffs (like blood pressure cuffs) are used to squeeze the blood vessels in your lower body. This helps improve blood flow to the heart and helps create natural bypasses (collateral circulation) around blocked coronary arteries. Enhanced external counterpulsation is a possible treatment for those with chronic stable angina who can’t have an invasive procedure or bypass surgery and don't get relief from medication.