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Treatments and drugs

By Mayo Clinic staff

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Illustration showing a coronary artery stent Coronary artery stent

Treatment for coronary artery disease usually involves lifestyle changes and, if necessary, drugs and certain medical procedures.

Lifestyle changes
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.

Drugs
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. Boosting your high-density lipoprotein (HDL, or the "good") cholesterol may help, too. 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 opening up 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. If you've had a heart attack, ACE inhibitors reduce the risk of future attacks.
  • Calcium channel blockers. These medications relax the muscles that surround your coronary arteries and cause the vessels to open, increasing blood flow to your heart. They also control high blood pressure.

Procedures to restore and improve blood flow
Sometimes more aggressive treatment is needed. Here are a few options:

  • Angioplasty and stent placement (percutaneous coronary revascularization). In this procedure, 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.
Alternative medicine Tests and diagnosis
References
  1. Coronary artery disease. National Lung, Heart, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Cad/CAD_WhatIs.html. Accessed May 22, 2012.
  2. Hall SL, et al. Secondary prevention of coronary artery disease. American Family Physician. 2010;81:289.
  3. The 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/guidelines/hypertension/. Accessed May 9, 2012.
  4. 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/index.htm. Accessed May 9, 2012.
  5. Natural medicines in the clinical management of hyperlipidemia. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 9, 2012.
  6. Natural medicines in the clinical management of hypertension. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 9, 2012.
  7. 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 May 23, 2012.
  8. Wilson PWF. Overview of the risk factors for cardiovascular disease. http://www.uptodate.com/index. Accessed May 23, 2012.
DS00064 June 29, 2012

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