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

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 »

Optimism and your health

Numerous studies have shown an association between a positive, optimistic life outlook and lower risk of heart attack, high blood pressure, and coronary artery disease, as well as better overall health and improved longevity. More »

Exercise and your arteries

Regular exercise is crucial to keeping the circulatory system functioning optimally, which in turn is beneficial to overall health and protection from heart disease. (Locked) More »