Topic: Coronary Heart Disease
Question: What are the treatments for Coronary Heart Disease ?
Answer: Treatments for coronary heart disease include heart-healthy lifestyle changes, medicines, medical procedures and surgery, and cardiac rehabilitation. Treatment goals may include:
                
Lowering the risk of blood clots forming (blood clots can cause a heart attack)
                
Preventing complications of coronary heart disease
                
Reducing risk factors in an effort to slow, stop, or reverse the buildup of plaque
                
Relieving symptoms
                
Widening or bypassing clogged arteries
                

                
Heart-Healthy Lifestyle Changes
                
Your doctor may recommend heart-healthy lifestyle changes if you have coronary heart 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 heart-healthy eating, which should include:
                
Fat-free or low-fat dairy products, such as fat-free 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:
                
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 canraise 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 coronary heart 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
                
Research shows that the most commonly reported trigger for a heart attack is an emotionally upsetting eventparticularly one involving anger. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy.
                
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 coronary heart disease 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 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 10 minutes 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
                
Sometimes lifestyle changes arent enough to control your blood cholesterol levels. For example, you may need statin medications to control or lower your cholesterol. By lowering your cholesterol level, you can decrease your chance of having a heart attack or stroke. Doctors usually prescribe statins for people who have:
                
Coronary heart disease, peripheral artery disease, or had a stroke
                
Diabetes
                
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.
                
Your doctor also may prescribe other medications to:
                
Decrease your chance of having a heart attack or dying suddenly.
                
Lower your blood pressure.
                
Prevent blood clots, which can lead to heart attack or stroke.
                
Prevent or delay the need for a stent or percutaneous coronary intervention (PCI) or surgery, such as coronary artery bypass grafting (CABG).
                
Reduce your hearts workload and relieve coronary heart disease symptoms.
                
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. You should still follow a heart healthy lifestyle, even if you take medicines to treat your coronary heart disease.
                

                
Medical Procedures and Surgery
                
You may need a procedure or surgery to treat coronary heart disease. Both PCIand CABG are used to treat blocked coronary arteries. You and your doctor can discuss which treatment is right for you.
                
Percutaneous Coronary Intervention
                
Percutaneous coronary intervention, commonly known as angioplasty, 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. The stent helps prevent blockages in the artery in the months or years after angioplasty. Read more about this procedure at PCI.
                
Coronary Artery Bypass Grafting
                
CABG is a type of surgery in which arteries or veins from other areas in your body are used to bypass (that is, go around) your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.
                
Read more about this surgery at CABG.
                
Cardiac Rehabilitation
                
Your doctor may prescribe cardiac rehabilitation (rehab) for angina or after CABG, angioplasty, or a heart attack. Nearly everyone who has coronary heart disease can benefit from cardiac rehab. Cardiac rehab is a medically supervised program that may help improve the health and well-being of people who have heart problems.
                
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:
                
Education, counseling, and training. This part of rehab 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 how to deal with your fears about the future.
                
Exercise training. This part 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.
                
Read more about this therapy at Cardiac Rehabilitation.
Source: NHLBI