Topic: Carotid Artery Disease
Question: What are the treatments for Carotid Artery Disease ?
Answer: Treatments for carotid artery disease may include healthy lifestyle changes, medicines, and medical procedures. The goals of treatment are to stop the disease from getting worse and to prevent a stroke. Your treatment will depend on your symptoms, how severe the disease is, and your age and overall health.
                
Heart-Healthy Lifestyle Changes
                
Your doctor may recommend heart-healthy lifestyle changes if you have carotid artery disease. Heart-healthy lifestyle changes include:
                
Heart-healthy eating
                
Maintaining a healthy weight
                
Managing stress
                
Physical activity
                
Quitting smoking
                
Heart-Healthy Eating
                
Your doctor may recommend a heart-healthy eating plan, which should include:
                
Fat-free or low-fat dairy products, such as skim milk
                
Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
                
Fruits, such as apples, bananas, oranges, pears, and prunes
                
Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
                
Vegetables, such as broccoli, cabbage, and carrots
                
Whole grains, such as oatmeal, brown rice, and corn tortillas
                
When following a heart-healthy diet, you should avoid eating:
                
A lot of red meat
                
Palm and coconut oils
                
Sugary foods and beverages
                
Two nutrients in your diet make blood cholesterol levels rise:
                
Saturated fatfound mostly in foods that come from animals
                
Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats andmeats.
                
Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:
                
If you eat:
                
Try to eat no more than:
                
1,200 calories a day                 
                
 8 grams of saturated fat a day      
                
1,500 calories a day
                
10 grams of saturated fat a day
                
1,800 calories a day
                
12 grams of saturated fat a day
                
2,000 calories a day
                
13 grams of saturated fat a day
                
2,500 calories a day
                
17 grams of saturated fat a day
                
Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels.
                
Some sources of monounsaturated and polyunsaturated fats are:
                
Avocados
                
Corn, sunflower, and soybean oils
                
Nuts and seeds, such as walnuts
                
Olive, canola, peanut, safflower, and sesame oils
                
Peanut butter
                
Salmon and trout
                
Tofu
                
Sodium
                
You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
                
Dietary Approaches to Stop Hypertension
                
Your doctor may recommend the Dietary Approaches to Stop Hypertension (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 and salt.
                
The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH.
                
Alcohol
                
Try to limit alcohol intake. Too much alcohol can raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may 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:
                
12 ounces of beer
                
5 ounces of wine
                
1 ounces of liquor
                
Maintaining a Healthy Weight
                
Maintaining a healthy weight is important for overall health and can lower your risk for carotid artery disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.
                
Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institutes (NHLBI) online BMI calculator or talk to your doctor. A BMI:
                
Below 18.5 is a sign that you are underweight.
                
Between 18.5 and 24.9 is in the normal range.
                
Between 25 and 29.9 is considered overweight.
                
Of 30 or more is considered obese.
                
A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.
                
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk.
                
If youre overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.
                
Managing Stress
                
Managing and coping with stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:
                
A stress management program
                
Meditation
                
Physical activity
                
Relaxation therapy
                
Talking things out with friends or family
                
Physical Activity
                
Routine physical activity can lower many risk factors for coronary heart disease, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent coronary heart disease.
                
Everyone should try to participate in moderate-intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10minutes at a time spread throughout the week.
                
Read more about physical activity at:
                
Physical Activity and Your Heart
                
U.S. Department of Health and Human Services 2008 Physical Activity Guidelines forAmericans
                
Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.
                
Quitting Smoking
                
If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.
                
If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
                
Read more about quitting smoking at Smoking and Your Heart.
                
Medicines
                
If you have a stroke caused by a blood clot, you may be given a clot-dissolving, or clot-busting, medication. This type of medication must be given within 4 hours of symptom onset. The sooner treatment occurs, the better your chances of recovery. If you think youre having a stroke, call 911 right away for emergency care.
                
Medicines to prevent blood clots are the mainstay treatment for people who have carotid artery disease. They prevent platelets from clumping together and forming blood clots in your carotid arteries, which can lead to a stroke. Two common medications are:
                
Aspirin
                
Clopidogrel
                
Sometimes lifestyle changes alone arent enough to control your cholesterol levels. For example, you also may need statin medications to control or lower your cholesterol. By lowering your blood cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have:
                
Diabetes
                
Heart disease or have had a stroke
                
High LDL cholesterol levels
                
Doctors may discuss beginning statin treatment with those who have an elevated risk for developing heart disease or having a stroke.
                
You may need other medications to treat diseases and conditions that damage the carotid arteries. Your doctor also may prescribe medications to:
                
Lower your blood pressure.
                
Lower your blood sugar level.
                
Prevent blood clots from forming, which can lead to stroke.
                
Prevent or reduce inflammation.
                
Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to. Your health care team will help find a treatment plan thats right for you.
                
Medical Procedures
                
You may need a medical procedure if you have symptoms caused by the narrowing of the carotid artery. Doctors use one of two methods to open narrowed or blocked carotid arteries: carotid endarterectomy and carotid artery angioplasty and stenting.
                
Carotid Endarterectomy
                
Carotid endarterectomy is mainly for people whose carotid arteries are blocked 50percent ormore.
                
For the procedure, a surgeon will make a cut in your neck to reach the narrowed or blocked carotid artery. Next, he or she will make a cut in the blocked part of the artery and remove the arterys inner lining that is blocking the blood flow.
                
Finally, your surgeon will close the artery with stitches and stop any bleeding. He or she will then close the cut in your neck.
                
Carotid Endarterectomy
                

                
Carotid Artery Angioplasty and Stenting
                
Doctors use a procedure called angioplasty to widen the carotid arteries and restore blood flow to the brain.
                
A thin tube with a deflated balloon on the end is threaded through a blood vessel in your neck to the narrowed or blocked carotid artery. Once in place, the balloon is inflated to push the plaque outward against the wall of the artery.
                
A stent (a small mesh tube) is then put in the artery to support the inner artery wall. The stent also helps prevent the artery from becoming narrowed or blocked again.
                
Carotid Artery Stenting
(Source: NHLBI)