How is CAD Treated?
Treatments for CAD include lifestyle changes, medicines and medical procedures. Treatment goals may include:
- Relieving symptoms.
- Reducing risk factors in an effort to slow, stop or reverse the buildup of plaque.
- Lowering the risk of blood clots forming.
- Widening or bypassing clogged arteries.
- Preventing complications of CAD.
Making lifestyle changes can often help prevent or treat CAD. Lifestyle changes might be the only treatment that some people need.
Follow a Healthy Diet
A healthy diet is an important part of a healthy lifestyle. Following a healthy diet can prevent or reduce high blood pressure and high blood cholesterol and help you maintain a healthy weight.
Your doctor may recommend therapeutic lifestyle changes (TLC) if you have high blood cholesterol. TLC is a three-part program that includes a healthy diet, physical activity and weight management.
With the TLC diet, less than 7 percent of your daily calories should come from saturated fat. This kind of fat is found in some meats, dairy products, chocolate, baked goods and deep-fried and processed foods.
No more than 25 to 35 percent of your daily calories should come from all fats, including saturated, trans, monounsaturated and polyunsaturated fats.
You also should have less than 200 mg a day of cholesterol. The amount of cholesterol and the types of fat in prepared foods can be found on the foods' Nutrition Facts label.
Foods high in soluble fiber also are part of a healthy diet. They help prevent the digestive tract from absorbing cholesterol. These foods include:
- Whole-grain cereals such as oatmeal and oat bran.
- Fruits such as apples, bananas, oranges, pears and prunes.
- Legumes such as kidney beans, lentils, chick peas, black-eyed peas and lima beans.
A diet rich in fruits and vegetables can increase important cholesterol-lowering compounds in your diet. These compounds, called plant stanols or sterols, work like soluble fiber.
A healthy diet also includes some types of fish, such as salmon, tuna (canned or fresh) and mackerel. These fish are a good source of omega-3 fatty acids, which may help protect the heart from blood clots as well as inflammation and reduce the risk of heart attack. Try to have about two fish meals every week.
You should also try to limit the amount of sodium (salt) that you eat. This means choosing low-salt and "no added salt" foods and seasonings at the table and while cooking. The Nutrition Facts label on packaged foods shows the amount of sodium in the item.
Try to limit drinks that contain alcohol; too much alcohol will raise your blood pressure and triglyceride (a type of fat in the blood) level. Alcohol also adds extra calories, which will cause weight gain.
Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is a glass of wine, beer or a small amount of hard liquor.
Dietary Approaches to Stop Hypertension (DASH). Your doctor may recommend the DASH eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains and other foods that are heart healthy and low in fat, cholesterol and sodium.
DASH also focuses on fat-free or low-fat milk and dairy products, fish, poultry and nuts. The DASH eating plan reduces red meats (including lean red meats), sweets, added sugars and sugar-containing beverages. It's rich in nutrients, protein and fiber.
The DASH eating plan is a good healthy eating plan, even for those who don’t have high blood pressure.
Be Physically Active
Routine physical activity can lower many CAD risk factors, including LDL ("bad") cholesterol, high blood pressure and excess weight.
Physical activity also can lower your risk for diabetes and raise your HDL (“good”) cholesterol level.
People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. The more active you are, the more you will benefit.
Talk with your doctor before you start a new exercise plan. Ask how much and what kinds of physical activity are safe for you.
Maintain a Healthy Weight
Maintaining a healthy weight can lower your risk for CAD. Body mass index (BMI) measures your weight in relation to your height and gives an estimate of your total body fat. A general goal to aim for is a BMI of less than 25. A BMI between 25 and 29.9 is considered overweight, a BMI of 30 or more is considered obese and a BMI of less than 25 is the goal for preventing and treating CAD. You can use an online calculator
to figure out your BMI. Your doctor or other health care provider also can help you determine your BMI and set an appropriate BMI goal.
Smoking can raise your risk for CAD and heart attack and worsen other CAD risk factors. If you smoke, we can help you quit through our Tobacco Free PATH program
. Also, talk with your doctor about medicines that can help you quit smoking. Finally, try to avoid secondhand smoke.
Research shows that the most commonly reported "trigger" for a heart attack is an emotionally upsetting event - particularly one involving anger. The ways in which some people cope with stress, such as drinking, smoking, or overeating, can also contribute to CAD.
It's important to learn how to manage stress, relax and effectively cope with problems in order to improve your emotional and physical health. Below are some strategies to help you do this:
- Seek supportive people in your life with whom you can share your feelings or concerns to help relieve stress.
- Be physically active
- Talk to your doctor about available medicines
- Take part in relaxation therapy.
- Join a stress management program.
If lifestyle changes aren't enough, you may need medicines to treat CAD. Medicines can:
- Relieve CAD symptoms.
- Reduce your heart’s workload.
- Decrease your chance of having a heart attack or dying suddenly.
- Lower your cholesterol and blood pressure.
- Prevent blood clots.
- Prevent or delay the need for a procedure or surgery.
Medicines used to treat CAD include anticoagulants, also called blood thinners; aspirin and other anticlotting medicines; ACE inhibitors; beta blockers; calcium channel blockers; nitroglycerin; statins; and fish oil and other supplements high in omega-3 fatty acids. You and your doctor can discuss what medicines are right for you.
It's important to take medicines exactly as your doctor ordered. Never skip a dose or stop taking your medicines without first talking to your doctor. Taking your medicines as prescribed combined with leading a healthy lifestyle will help you manage your health condition.
Procedures and Surgery
You may need a procedure or surgery to treat CAD. You and your doctor can decide which treatment is right for you.
Angioplasty, also called percutaneous coronary intervention (PCI), is a nonsurgical procedure that opens blocked or narrowed coronary arteries. A thin, flexible tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Once in place, the balloon is inflated to compress the plaque against the wall of the artery. This restores blood flow through the artery. During the procedure, the doctor may put a small mesh tube called a stent in the artery to help prevent blockages.
Coronary Artery Bypass Grafting (CABG)
Coronary Artery Bypass Grafting (CABG), is a surgery in which arteries or veins from other areas in your body are used to bypass, or go around, your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain and possibly prevent a heart attack.
Cardiac rehabilitation (rehab) is a medically supervised program that may help improve the health and well-being of people who have heart problems. Your doctor may prescribe cardiac rehab for angina or after CABG, angioplasty or a heart attack. Almost everyone who has CAD can benefit from cardiac rehab.
The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.
Rehab has two parts:
- Exercise training helps you learn how to exercise safely, strengthen your muscles and improve your stamina. Your exercise plan will be based on your personal abilities, needs and interests.
- Education, counseling and training helps you understand your heart condition and find ways to reduce your risk for future heart problems. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and deal with your fears about the future.