Coronary heart disease cannot be cured, but recent progress in the research and development of new medicines and significant improvements in surgical procedures have meant that the condition can now be managed more effectively. With the right treatment, the symptoms of coronary heart disease can be reduced and the functioning of the heart improved.
Many different medicines are used to treat CHD. This gives doctors a wide choice and means that a medication can be prescribed to meet your particular circumstances and needs. Some heart medicines have side effects, so it may take a while to find one that works for you. Your GP or specialist will be able to discuss the various options with you.
Some of the medicines that are commonly used to treat heart conditions are outlined below.
Low-dose aspirin medication
Blood clots in the coronary arteries are a major cause of heart attacks. A low-dose aspirin and/or other anti platelet medicine may be prescribed for you by your doctor, unless there are reasons not to, for example if you have a bleeding disorder. This type of medicine will help prevent your blood clotting, reducing your risk of heart attack and angina.
More about taking aspirin
Anticoagulants such as warfarin are sometimes used to stop the blood clotting. If you are prescribed warfarin, you will need regular blood tests to ensure your clotting rate is within an agreed limit. This is called the INR test. It is also a good idea to carry a card with you stating that you are taking an anticoagulant.
A high level of 'bad cholesterol' (LDL) in your blood can cause a build up of atheroma (fatty deposits) in your arteries, increasing your risk of heart attack or stroke. If you have a high blood cholesterol level, cholesterol-lowering medicine called statins may be prescribed.
Statins work by blocking the formation of cholesterol and increasing the number of LDL ‘receptors’ in the liver, which, in conjunction with any lifestyle modifications discussed with you, will help to remove the LDL cholesterol from your blood. This all helps to slow the progression of CHD, making having a heart attack less likely.
More about taking statins
Beta-blockers are often used to prevent angina and treat high blood pressure. They work by blocking the effects of stress hormones, which make your heart beat faster and harder. This slows down your heartbeat, improves blood flow and helps your heart to pump more effectively. Beta blockers are usually taken alongside ACE inhibitors (see below). Your doctor may decide that beta blockers are not suitable for you especially if you have respiratory problems, such as asthma or diabetes. You may also be prescribed diuretics (medicine that helps your body get rid of extra fluid).
More about taking beta-blockers
ACE (angiotensin-converting enzyme) inhibitors
ACE inhibitors are commonly used to treat heart failure and high blood pressure. If you have had a heart attack, they are also used to help reduce the risk of you having a further heart attack. They block the activity of a hormone (called angiotensin II), which narrows blood vessels. As well as stopping your heart working so hard, ACE inhibitors improve the flow of blood around the body.
Your blood pressure will be monitored while you are taking ACE inhibitors. ACE inhibitors can affect the function of your kidneys, so your GP will give you regular blood tests to check that your kidneys are working properly.
If ACE inhibitors have been prescribed for you, do not stop taking them without first consulting you doctor. If you do, it is very likely that your symptoms will get worse quickly. Common side effects of ACE inhibitors include a dry cough, dizziness and fainting. Please discuss potential side affects with your GP.
Angiotensin II receptor antagonists
Angiotensin II receptor antagonists work in a similar way to ACE inhibitors. They are used to lower your blood pressure by limiting angiotensin II. These are usually prescribed if you are experiencing side effects from ACE inhibitors as an alternative. Mild dizziness is usually the only side effect from angiotensin II antagonists.
Anti-arrhythmic medicine is sometimes used to control the rhythm of your heart. It is important to remember to take your prescribed dose daily, as this type of medicine is most effective when exactly the right level is in your bloodstream, so it is important that the correct dosage is taken.
Nitrates are used to widen your blood vessels. Doctors sometimes refer to nitrates as vasodilators. They are available in a variety of forms, including tablets, sprays and skin patches. They work by relaxing your blood vessels, letting more blood pass through them. This lowers your blood pressure and aims to relieve symptoms of angina that you have. Nitrates can have some mild side effects, including headaches, dizziness and flushed skin.
Cardiac glycosides, such as digoxin, strengthen and slow the heartbeat. By making the heart muscles contract (squeeze together) more strongly, blood is pushed around the body with more force. Cardiac glycosides are usually only taken in addition to other medicine, such as ACE inhibitors and diuretics.
If your blood vessels are very narrow due to a build up of atheroma (fatty deposits), or if your symptoms cannot be controlled using medication, surgery may be needed to open up or replace the blocked arteries. Some of the main surgical procedures that can be used to treat blocked arteries are outlined below.
Coronary angioplasty is sometimes used to treat mild coronary heart disease. An angioplasty opens up a blocked or narrowed coronary artery, improving the blood flow to the heart.
More about having a coronary angioplasty
In a small number of cases, when the heart is severely damaged and medicine is not effective, or when the heart becomes less efficient at pumping blood around the body (heart failure), a heart transplant may be needed. A heart transplant involves replacing a heart that is damaged or is not working properly with a healthy donor heart.
Not all people are suitable candidates for having a heart transplant, and finding a suitable donor may take many months. However, the success rate of heart transplant surgery has improved significantly over the past few decades, and many people who have had transplants more than ten years ago are still doing well.
Although heart transplant surgery is usually a successful procedure, afterwards you will need to take medicine to control your immune system's reaction to having a 'foreign heart'. The medicine can cause your immune system to become weaker, making you more vulnerable to illness and infection. Your doctor may also prescribe medicine to help reduce your risk of a having heart attack.
More about having a heart transplant
Research into heart-related problems continues. Much of this is funded by charities, and doctors are looking at new ways of preventing the body rejecting donor hearts, as well as developing new treatments so that people with heart conditions can live long, healthy lives. In the future, cardiologists (heart doctors) hope to be able to investigate, diagnose and treat heart conditions without the need for using surgical procedures.