Treatment for coronary artery disease usually involves lifestyle changes and, if necessary, drugs and certain medical procedures.
Making a commitment to the following healthy lifestyle changes can go a long way toward promoting healthier arteries:
- Quit smoking.
- Eat healthy foods.
- Exercise regularly.
- Lose excess weight.
- Reduce stress.
Various drugs can be used to treat coronary artery disease, including:
- Cholesterol-modifying medications. By decreasing the amount of cholesterol in the blood, especially low-density lipoprotein (LDL, or the "bad") cholesterol, these drugs decrease the primary material that deposits on the coronary arteries. Your doctor can choose from a range of medications, including statins, niacin, fibrates and bile acid sequestrants.
Aspirin. Your doctor may recommend taking a daily aspirin or other blood thinner. This can reduce the tendency of your blood to clot, which may help prevent obstruction of your coronary arteries.
If you've had a heart attack, aspirin can help prevent future attacks. There are some cases where aspirin isn't appropriate, such as if you have a bleeding disorder or you're already taking another blood thinner, so ask your doctor before starting to take aspirin.
- Beta blockers. These drugs slow your heart rate and decrease your blood pressure, which decreases your heart's demand for oxygen. If you've had a heart attack, beta blockers reduce the risk of future attacks.
- Nitroglycerin. Nitroglycerin tablets, sprays and patches can control chest pain by temporarily dilating your coronary arteries and reducing your heart's demand for blood.
- Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). These similar drugs decrease blood pressure and may help prevent progression of coronary artery disease.
Procedures to restore and improve blood flow
Sometimes more aggressive treatment is needed. Here are some options:
Angioplasty and stent placement (percutaneous coronary revascularization). Your doctor inserts a long, thin tube (catheter) into the narrowed part of your artery. A wire with a deflated balloon is passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls.
A stent is often left in the artery to help keep the artery open. Some stents slowly release medication to help keep the artery open.
- Coronary artery bypass surgery. A surgeon creates a graft to bypass blocked coronary arteries using a vessel from another part of your body. This allows blood to flow around the blocked or narrowed coronary artery. Because this requires open-heart surgery, it's most often reserved for cases of multiple narrowed coronary arteries.
Omega-3 fatty acids are a type of unsaturated fatty acid that's thought to reduce inflammation throughout the body, a contributing factor to coronary artery disease. However, recent studies have not shown them to be beneficial. More research is needed.
- Fish and fish oil. Fish and fish oil are the most effective sources of omega-3 fatty acids. Fatty fish — such as salmon, herring and light canned tuna — contain the most omega-3 fatty acids and, therefore, the most benefit. Fish oil supplements may offer benefit, but the evidence is strongest for eating fish.
- Flax and flaxseed oil. Flax and flaxseed oil also contain beneficial omega-3 fatty acids, though studies have not found these sources to be as effective as fish. The shell on raw flaxseeds also contains soluble fiber, which can help lower blood cholesterol.
- Other dietary sources of omega-3 fatty acids. Other dietary sources of omega-3 fatty acids include canola oil, soybeans and soybean oil. These foods contain smaller amounts of omega-3 fatty acids than do fish and fish oil, and evidence for their benefit to heart health isn't as strong.
Other supplements may help reduce your blood pressure or cholesterol level, two contributing factors to coronary artery disease. These include:
- Alpha-linolenic acid (ALA)
- Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ)
- Blond psyllium
- Coenzyme Q10
- Oat bran (found in oatmeal and whole oats)
- Sitostanol (found in oral supplements and some margarines, such as Benecol)
Aug. 04, 2017
- Ferri FF. Coronary artery disease. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. https://www.clinicalkey.com. Accessed Oct. 12, 2015.
- Coronary heart disease. National Lung, Heart, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/cad. Accessed Oct. 12, 2015.
- Usatine RP, et al., eds. Coronary artery disease. In: The Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013. http://www.accessmedicine.com. Accessed Oct. 13, 2015.
- Wilson PWF. Overview of the possible risk factors for cardiovascular disease. http://www.uptodate.com/home. Accessed Oct. 13, 2015.
- Longo DL, et al. Ischemic heart disease. In: Harrison's Principles of Internal Medicine. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed Oct. 13, 2015.
- Understanding blood pressure readings. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp. Accessed Oct. 13, 2015.
- Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health-pro/guidelines/current/hypertension-jnc-7. Accessed Oct. 12, 2015.
- Your guide to lowering your cholesterol with therapeutic lifestyle changes (TLC). National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/resources/heart/cholesterol-tlc. Accessed Oct. 12, 2015.
- Eckel RH, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk. Circulation. 2014;129:S76.
- Franzese CJ, et al. Relation of fish oil supplementation to markers of atherothrombotic risk in patients with cardiovascular disease not receiving lipid-lowering therapy. American Journal of Cardiology. 2015;115:1204.
- Omega-3 supplements: An introduction. National Center for Complementary and Alternative Medicine. https://nccih.nih.gov/health/omega3/introduction.htm. Accessed Oct. 13, 2015.
- Tani S, et al. Association of fish consumption-derived ratio of serum n-3 to n-6 polyunsaturated fatty acids and cardiovascular risk with the prevalence of coronary artery disease. International Heart Journal. 2015;56:260.
- Fish and omega-3 fatty acids. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Fish-and-Omega-3-Fatty-Acids_UCM_303248_Article.jsp. Accessed Oct. 13, 2015.
- Natural product effectiveness checker: Hypertension. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 13, 2015.
- Natural product effectiveness checker: High cholesterol. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 13, 2015.
- High blood pressure. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 13, 2015.
- Riggs ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Sept. 10, 2015.
- Hypertension in adults: Screening and home monitoring. U.S. Preventive Services Task Force.http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/high-blood-pressure-in-adults-screening. Accessed Nov. 18, 2015.