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Treatments and drugs
By Mayo Clinic staffLifestyle changes, such as eating a healthy diet and exercising, are often the best treatment for atherosclerosis. But sometimes, medication or surgical procedures may be recommended as well.
Various drugs can slow — or sometimes even reverse — the effects of atherosclerosis. Here are some common choices:
- Cholesterol medications. Aggressively lowering your low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol, can slow, stop or even reverse the buildup of fatty deposits in your arteries. Boosting your high-density lipoprotein (HDL) cholesterol, the "good" cholesterol, may help, too. Your doctor can choose from a range of cholesterol medications, including drugs known as statins and fibrates.
- Anti-platelet medications. Your doctor may prescribe anti-platelet medications, such as aspirin, to reduce the likelihood that platelets will clump in narrowed arteries, form a blood clot and cause further blockage.
- Beta blocker medications. These medications are commonly used for coronary artery disease. They lower your heart rate and blood pressure, reducing the demand on your heart and often relieve symptoms of chest pain. Beta blockers reduce the risk of heart attacks and heart rhythm problems.
- Angiotensin-converting enzyme (ACE) inhibitors. These medications can help slow the progression of atherosclerosis by lowering blood pressure and producing other beneficial effects on the heart arteries. ACE inhibitors can also reduce the risk of recurrent heart attacks.
- Calcium channel blockers. These medications lower blood pressure and are sometimes used to treat angina.
- Water pills (diuretics). High blood pressure is a major risk factor for atherosclerosis. Diuretics lower blood pressure.
- Other medications. Your doctor may suggest certain medications to control specific risk factors for atherosclerosis, such as diabetes. Sometimes specific medications to treat symptoms of atherosclerosis, such as leg pain during exercise, are prescribed.
Sometimes more aggressive treatment is needed. If you have severe symptoms or a blockage that threatens muscle or skin tissue survival, you may be a candidate for one of the following surgical procedures:
- Angioplasty. In this procedure, your doctor inserts a long, thin tube (catheter) into the blocked or narrowed part of your artery. A second catheter with a deflated balloon on its tip is then passed through the catheter to the narrowed area. The balloon is then inflated, compressing the deposits against your artery walls. A mesh tube (stent) is usually left in the artery to help keep the artery open.
- Endarterectomy. In some cases, fatty deposits must be surgically removed from the walls of a narrowed artery. When the procedure is done on arteries in the neck (the carotid arteries), it's known as carotid endarterectomy.
- Thrombolytic therapy. If you have an artery that's blocked by a blood clot, your doctor may insert a clot-dissolving drug into your artery at the point of the clot to break it up.
- Bypass surgery. Your doctor may create a graft bypass using a vessel from another part of your body or a tube made of synthetic fabric. This allows blood to flow around the blocked or narrowed artery.
References
- Atherosclerosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Atherosclerosis/Atherosclerosis_All.html. Accessed April 30, 2010.
- Atherosclerosis. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4440. Accessed April 30, 2010.
- The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/express.pdf. Accessed April 30, 2010.
- Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf. Accessed April 19, 2010.
- Sanz J, et al. Imaging of atherosclerotic disease. Nature. 2008;451:953.
- Lopez L, et al. Lifestyle modification counseling for hypertensive patients: Results from the National Health and Nutrition Examination Survey 1999-2004. American Journal of Hypertension. 2009;22:325.
- Villegas R, et al. The cumulative effect of core lifestyle behaviours on the prevalence of hypertension and dyslipidemia. BMC Public Health. 2008;8:210.
- Appel LJ, et al. Dietary approaches to prevent and treat hypertension: A scientific statement from the American Heart Association. Hypertension. 2006;47:296.
- Natural medicines in the clinical management of hyperlipidemia. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed April 28, 2010.
- Natural medicines in the clinical management of hypertension. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed April 28, 2010.
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