Coronary Artery Disease

The term "heart disease," also known as cardiovascular disease, covers a lot of ground. It's used for a variety of problems with the circulatory system, from high blood pressure to abnormal heart rhythms. Most of the time, though, when people speak of heart disease what they really mean is coronary artery disease—a narrowing of the coronary arteries. No wider than a strand of spaghetti, each coronary artery deliver bloods to hard-working heart muscle cells.

The cause of coronary artery disease is almost always atherosclerotic plaque—gooey cholesterol-filled deposits that form inside artery walls. Plaque is usually the result of an unhealthy diet, too little exercise, high cholesterol, high blood pressure, smoking, and other "insults" that damage the lining of artery walls.

When a coronary artery becomes clogged with plaque, it can't always deliver enough blood to the heart muscle cells it is supposed to supply. Sometimes this doesn't cause any noticeable symptoms. Sometimes it causes angina — chest pain that occurs with physical exertion or stress. Coronary artery disease can also be the root cause of a heart attack, or lead to the chronic condition known as heart failure.

Coronary artery disease affects millions of Americans. Once limited almost entirely to older people, it is now beginning to appear in younger folks, a change driven by the rising tides of obesity and type 2 diabetes.

Coronary artery disease isn't an inevitable part of growing older. A healthy lifestyle that includes exercise, a healthy diet, and not smoking goes a long way to preventing it, especially when started at a young age. Lifestyle changes and medications can also reverse coronary artery disease, or at least prevent it from getting worse.

Coronary Artery Disease Articles

Medication management for CAD

People with heart disease often are prescribed a number of medications. Learning what each one is for and which side effects they may cause and remembering to take them on schedule can be a daunting task. Support is needed from the prescribing physician, from caregivers, and from family and friends. Tools—some as old-fashioned as wall calendars, some as new as mobile phone apps and smart pillboxes—can help people properly take and track the heart medications they need. (Locked) More »

Bypass or angioplasty with stenting: How do you choose?

Up to a third of people with coronary artery disease have blockages in all three of the arteries that feed the heart muscle. For them, bypass surgery usually is the best treatment option. For those with a blockage only in the LAD, the coronary artery that feeds the entire front of the heart, bypass is also the best treatment. But when the LAD isn’t involved, blockage in one or even two of the other coronary arteries usually is treated with balloon angioplasty to widen the artery and placement of a mesh tube called a stent to hold it open. (Locked) More »

Blood type associated with risk

Type O blood is associated with the lowest risk of coronary artery disease. People with type A, B, and AB have risks 5%, 10%, and 23% higher than those with type O, respectively. (Locked) More »

Is angioplasty right for you?

Although nearly 80% of people who undergo angioplasty and stenting discuss the procedure with their doctor, less than 20% are told about possible drawbacks, and only 10% are told about other options. This is worrisome, because surgery or drug therapy may be a better option for some. People with coronary artery disease are encouraged to make an informed decision by asking their doctor to explain the potential benefits and risks of the recommended procedure, whether there are alternatives, and how the benefits and risks of the options compare. (Locked) More »

Green tea may lower heart disease risk

Green tea can significantly lower LDL cholesterol and triglycerides, and this may explain why green tea drinkers have a lower risk of coronary artery disease and death from heart disease and stroke.   More »

The Healthy Heart: Preventing, detecting, and treating coronary artery disease

Although lifestyle changes are an essential first step in treating coronary artery disease, you may need to take medications to reach your cholesterol and blood pressure goals and otherwise reduce your risk. In fact, most people with heart disease need to take more than one medication. The specific combination of drugs will depend on your particular symptoms and risk factors. Some of the most commonly prescribed medications are described below. For many years, doctors used diuretics — sometimes known as water pills — to treat high blood pressure. Although diuretics remain a mainstay of blood pressure treatment because they are cheap and effective, a flood of other drugs have become available since the 1980s. In addition, a large meta-analysis comparing the various options concluded that the five categories of drugs currently available are equally effective for most people. Work with your doctor to determine the best type of medication for you. It is important to keep in mind, though, that most people with hypertension do not get their blood pressure under control with the starting dose of the first drug chosen. At that point, two philosophies exist about what to try next. Some doctors increase the dosage of the first drug to see if it will bring blood pressure down to target levels. The advantage of this approach is simplicity, as the person being treated takes one pill per day. A second approach is to use low doses of two or more blood pressure drugs that work in different ways. This approach minimizes the likelihood of side effects, but may be harder to follow, as it requires taking two or more pills per day. It may also be more expensive for the person being treated, as he or she may face additional copayments or out-of-pocket expenses for the drugs. A compromise approach is to use combination medicines that include, for example, both an ACE inhibitor and a low-dose diuretic. This is convenient, but many combinations are available only in brand-name forms and are thus more expensive. More »