How is cardiovascular disease treated?
Medication. If lifestyle changes aren't enough to control your heart disease, medication(s) may be prescribed to treat certain risk factors, such as high cholesterol or high blood pressure, to help your heart work more efficiently and receive more oxygen-rich blood. The medication(s) you will be prescribed will depend on your personal needs, presence of other health conditions and your specific heart problem.
Hormone replacement therapy (HRT). For many years, preliminary observational research showed that hormone replacement therapy (HRT) could possibly reduce the risk of heart disease in women. It appears that the reason why the observational studies showed a reduced risk of heart disease was likely due to the lifestyles of women who take HRT rather than medical benefits of the therapy.
More recent large-scale studies of women, such as the Heart and Estrogen/Progestin Replacement Study (HERS) and the Women's Health Initiative (WHI) concluded that the overall health risks of HRT exceeded the benefits.
Women who participated in HERS had an increased risk of heart attack and stroke during the first year of HRT. After two years of treatment, this risk appeared to be reduced in women taking HRT compared with women who were not taking HRT. Women who participated in the WHI study had an increased risk for breast cancer, coronary heart disease (including nonfatal heart attacks), stroke, blood clots, and gallbladder disease.
Based on the results of these studies, the American Heart Association and the U.S. Food and Drug Administration developed new guidelines for the use of HRT:
- Hormone replacement therapy should not be used for prevention of heart attack or stroke.
- The use of HRT for other problems such as preventing osteoporosis should be carefully considered, and the risks should be weighed against the benefits. Women who have existing coronary artery disease should consider other prevention options.
- Short-term HRT may be used to treat menopausal symptoms.
- Long-term HRT use is discouraged because the risk of heart attack, stroke and breast cancer increases the longer HRT is used.
The bottom line, say physicians at Cleveland Clinic's Sydell and Arnold Miller Family Heart & Vascular Institute: Weigh the benefits of HRT against the risks, and discuss the whole subject of HRT with your physician so you can make an informed decision.
Interventional procedures. Common interventional procedures to treat coronary artery disease include balloon angioplasty (PTCA) and stent or drug-eluting stent placement. These procedures are considered nonsurgical because they are done by a cardiologist through a tube or catheter that is inserted into a blood vessel, rather than by a surgeon, through an incision. Several types of balloons and/or catheters are available to treat the plaque within the vessel wall. The physician chooses the type of procedure to perform based on individual patient needs.
Coronary artery bypass surgery. During coronary artery bypass graft surgery, one or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart. These grafts usually come from the patient's own arteries and veins located in the chest, arm or leg. The graft goes around the clogged artery (or arteries) to create new pathways for oxygen-rich blood to flow to the heart.
Other options. Other procedures, such as enhanced external counterpulsation (EECP) are used when traditional therapies are not optional. Your doctor can provide more information about these procedures.