Coronary artery disease (CAD) is a result of plaque buildup in the arteries supplying blood to the heart. The buildup begins when a part of the artery is damaged, and a plaque forms to heal the site. Then, excess triglycerides and cholesterol attach to the plaque and form a blockage.
Coronary artery disease is the leading cause of death in the United States for men and women.
Procedures
For some people– especially those with only one artery affected– can be treated with medications and lifestyle changes. Some types of narrowing are more difficult to treat than others. According to the Mayo Clinic, “The treatment of coronary artery disease is individualized. The information from your cardiac catheterization will help you and your doctor determine which treatment option is best for you.”
Angioplasty opens blocked or narrowed coronary arteries by inflating a balloon into the artery to push the plaque outward. This procedure usually improves blood flow, relieves chest pain, and sometimes prevents heart attacks. A stent can be put in the artery to keep it open. It is less expensive and less invasive than CABG.
For arteries that are narrow or blocked in multiple areas, bypass surgery may be necessary. The coronary artery bypass surgery graft (CABG) procedure takes arteries or veins from other parts of your body and places them around the coronary arteries to act as a bypass. This procedure has the same effects as angioplasty.
Medication
Beta-blockers and calcium-channel blockers relieve chest pain, but do not clear blocked arteries. Beta-blockers (acebutelol, propranolol) reduce the amount of oxygen the heart requires when under stress. Some calcium-channel blockers (verapamil, diltiazem hydrochloride) keeps arteries open and reduces blood pressure (AARP).
Nitrates improve blood flow to the heart by widening (dilating) the blood vessels. This lessens the amount of blood returning to the heart from the body. Aspirin prevents blood clots, ad has been shown to improve survival rate after a heart attack.
CAD Prevention
The best way to avoid coronary artery disease is through prevention. Lowering LDL cholesterol and blood pressure can decrease your risk of CAD and stroke.
- Don’t smoke
- Exercise at least 30 minutes a day
- Moderate drinking
- Lower stress
- Healthy diet (low sodium, low saturated fat, moderate amount of calories.)
Dr. Hazen of the Cleveland Clinic’s Preventative Cardiology & Rehabilitation department, says that inflamed, fatty lesions are more of a risk for causing a sudden heart attack than the 90% narrowed arteries. “Therefore, simply opening every narrowed vessel observed is not the optimal thing to do. Rather, focusing on global risk reduction approaches, including exercise, diet, and medications like statins (to lower LDL cholesterol), certain blood pressure pills that also prevent the progression of heart disease and decrease the work of the heart, and low dose aspirin, are the major preventive approaches recommended.”
Homocystein is a protein that has been associated with CAD. Some people have a genetic defect that may result in premature CAD. A HCys genetic test exists to screen for people who are at an increased risk of CAD.
Coronary Artery Disease Treatments
Clinical trials have been ongoing for drugs that can reverse CAD. The Harvard Atherosclerosis Reversibility Project (HARP) tested the effectiveness of drugs in lowering blood lipoprotein cholesterol for patients with coronary heart disease. Another study by Boston University is testing an anti-inflammatory drug to reverse CAD damage. The ability to “reverse” CAD is currently being researched, at this time there is no “Drano” equivalent for the arteries.