Coronary artery disease: Risk factors, treatment options, and heart health

Coronary artery disease is a leading cause of heart-related complications, including heart attacks. Understanding the condition is therefore crucial for both prevention and effective management.

This article provides an expert insight into the causes of coronary artery disease, the available treatments, and the importance of regular follow-ups to support better heart health.

What causes coronary artery disease?

Coronary artery disease occurs when the coronary arteries, which deliver oxygen-rich blood to the heart muscle, become narrowed or blocked. This is caused by a process called atherosclerosis, where fatty deposits known as plaques, accumulate on the inner walls of the arteries. Over time, these plaques harden and restrict blood flow, leading to chest pain (angina), heart attack, or other complications.

Several factors contribute to coronary artery disease, including high low-density lipoprotein (LDL) cholesterol, lack of physical activity, and an unhealthy diet. Furthermore, high blood pressure can damage the arterial walls, and smoking accelerates atherosclerosis and reduces oxygen in the blood. Genetic predisposition is another important factor, with family history significantly increasing a person’s risk.

How is coronary artery disease treated?

Treatment for coronary artery disease depends on its severity, the presence of symptoms, and the risk of heart-related complications.

Lifestyle changes

For many patients, lifestyle changes form the cornerstone of coronary artery disease treatment. These modifications include adopting a heart-healthy diet (rich in fruits, vegetables, and whole grains), practising regular exercise, quitting smoking, and managing stress levels. Additionally, weight management is particularly important for patients with obesity.

Medications

Medications are commonly prescribed to manage coronary artery disease and reduce the risk of a heart attack. Statins are among the most frequently prescribed drugs. They work by lowering LDL cholesterol levels, which helps prevent plaque buildup and stabilises existing plaques, reducing the risk of rupture.

Moreover, aspirin and other antiplatelet drugs are often prescribed to prevent blood clots, which can form on plaques and lead to a heart attack. Beta-blockers, on the other hand, are used to reduce the workload on the heart by lowering heart rate and blood pressure, thereby decreasing symptoms like angina.

Other medications include ACE inhibitors or ARBs, which relax blood vessels and help control blood pressure, and calcium channel blockers, which improve blood flow and reduce chest pain. For patients experiencing acute angina, nitrates may be prescribed to dilate blood vessels and relieve discomfort.

Surgical interventions

In severe cases, surgical interventions such as angioplasty or coronary artery bypass grafting (CABG) may be necessary to restore blood flow to the heart. Angioplasty involves the insertion of a small balloon to widen the blocked artery, often with the use of a stent to keep the artery open. CABG is a more invasive procedure that reroutes blood flow around blocked arteries using a graft.

How is the risk of a heart attack assessed?

The risk of heart attack is assessed through a combination of various tools, including blood tests, imaging studies, and stress tests.

Blood tests measure markers like cholesterol levels, triglycerides, and high-sensitivity C-reactive protein, which indicate inflammation. Imaging studies, such as coronary angiography and CT scans, provide detailed views of arterial blockages. Stress tests evaluate how the heart functions under physical exertion, helping to identify areas of reduced blood flow.

These assessments assist in developing a personalised treatment plan tailored to the patient's specific condition.

How often should I follow-up with my cardiologist after being diagnosed with coronary artery disease?

Regular follow-ups are essential after being diagnosed with coronary artery disease. The frequency of these visits will depend on the severity of the condition, each patient’s specific risk factors, and the treatment plan.

For newly diagnosed patients or those recovering from procedures like stent placement or bypass surgery, follow-ups may be scheduled every 3 months initially. During these visits, the cardiologist will monitor heart health, review the medication regimen, and adjust treatments as needed.

Once the condition stabilises, follow-ups may occur once a year. However, patients with poorly controlled risk factors, such as high blood pressure or diabetes, will require more frequent appointments.

Importantly, it’s essential to seek immediate medical attention if new or worsening symptoms arise between scheduled visits, including persistent chest pain, shortness of breath, or dizziness, as these can signal a need for urgent intervention.