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Why manage cardiovascular disease?

Treatments for cardiovascular disease (CVD) have greatly improved health outcomes, leading to people living longer and healthier lives. For example, the American Heart Association points out that actively managing risk factors like high blood pressure, high cholesterol, and diabetes has helped lower health problems and deaths related to CVD. New medications for diabetes have also shown to be safe and effective, and lower the chances of death and heart failure in diabetic patients.

Treatments for CVD can significantly improve symptoms and quality of life. For instance, managing heart failure with advanced medications has been shown to help people live longer and keep people from needing hospitalization. With treatment, patients with heart failure are better in terms of their physical health and emotional well-being. Similarly, treatments for chronic coronary disease, like procedures to open blocked arteries with stents combined with the right medications, allow people to do activities without chest pain. These patients can do more activities with their family and friends, and have a better quality of life.

Dietary and Lifestyle Modifications

People with cardiovascular disease should make extra changes to their diet and lifestyle compared to those without the disease. These changes are very important for managing conditions like coronary artery disease, peripheral artery disease, heart failure, and for preventing further health problems.

 

Strokes, coronary artery disease, and peripheral artery disease

For people who have atherosclerotic disease (which includes coronary artery disease peripheral artery disease and strokes), eating a heart-healthy diet is essential. This means eating plenty of vegetables, fruits, nuts, whole grains, lean proteins, and fish, while cutting back on unhealthy fats, red meats, processed foods, refined carbohydrates, and sugary drinks. Organizations like the American College of Cardiology and the American Heart Association recommend heart-healthy foods to help slow down the progression of the disease and improve cholesterol levels. Regular exercise is also important, with at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous exercise recommended each week to boost heart health and reduce the risk of future health problems.

 

Heart failure

For people with heart failure, it i’s important to lower sodium intake to help manage fluid buildup and prevent worsening symptoms. Sodium in the diet is most commonly found in salt added to food. The American College of Cardiology suggests limiting sodium to less than 2,300 mg a day, and even less—about 1,500 mg—for those with high blood pressure. Eating fresh food and limiting processed foods can help a lot with limiting unnecessary sodium intake. Tailoring physical activity to what each individual can handle can also help improve symptoms and daily functioning.

 

The Role of Medications

Medication is very important for managing cardiovascular disease, which includes preventing problems, treating risk factors, and dealing with specific heart conditions like blocked arteries, heart failure, and irregular heartbeats.

Preventing heart disease in people at high risk

To prevent cardiovascular disease, medications like statins (such as atorvastatin or rosuvastatin) are key. Statins help lower bad cholesterol levels and reduce the risk of heart problems. The American College of Cardiology and the American Heart Association recommend these medications for people at higher risk, especially those with diabetes or other risk factors. Adults over the age of 40 years should check in with their primary care doctor once a year to see if their heart disease risk is high enough to benefit from one of these medications. For patients who do not tolerate these statin medications, there are also newer options for treatment to lower bad cholesterol.

Treating diseases that cause heart problems

When it comes to treating risk factors, medications play a big role. For high cholesterol, statins are the main choice, but other medications like ezetimibe and PCSK9 inhibitors can also help lower bad cholesterol even more. For high blood pressure, there are lots of effective treatments and people can work with their doctors to find a medication that is well -tolerated. For diabetic patients, improved heart health and decreased risk of death can occurs with use of medications such as, metformin, SGLT2 inhibitors (such as dapagliflozin or empagliflozin), and GLP-1 receptor agonists (such as semaglutide).

Treatments for tobacco cessation

Tobacco cessation aids, like nicotine patches and medications, are crucial for helping people quit tobacco use and reduce their heart disease risk. Support from a healthcare professional and from emotional support from family, friends, and groups all can help improve the chances of quitting nicotine products.

Treatments for coronary artery disease from atherosclerosis (blocked arteries)

Lowering cholesterol is key in patient who have had blocked arteries that have caused strokes, chest pain and heart attacks, and poor circulation. There are a number of medications that can help with cholesterol, particularly bad cholesterol or LDL.  Other medications, that reduce blood pressure such as for hypertension, can also help with slowing the build-up of cholesterol in blood vessels. A doctor or care provider may also recommend medications like aspirin and clopidogrel to prevent blood clots forming.

Treatments for heart failure
Treatment for heart failure is very important as untreated heart failure is usually fatal within a few years. With specific medications, people can see the heart’s pumping function recover, sometimes completely back to normal. Usually patients need to be on classes of medications called beta-blockers and renin-angiotensin system inhibitors, such as ACE inhibitors or angiotensin receptor blockeers. Other commonly used medications include medication classes including mineralcorticoid receptor antagonists and SGLT-2 inhibitors to further help the heart pump better. When certain patients do not have a good enough recovery in the heart failure, implantable devices are sometimes used to help the heart pump blood more effectively and to help decrease the chances of dying from arrhythmias.
Treatment for irregular heart beats
For irregular heartbeats, medications are frequently used to regulate the heart. These medications common include a class of medications called beta-blockers or calcium channel blockers. However, sometimes stronger medications called antiarrhythmic medications are used to manage symptoms and prevent issues. Patients with arrhythmias that are not optimally controlled with medications may need to undergo a procedure called an ablation. Ablations use focused energy delivered during a surgical procedure to destroy small areas of heart tissue that are causing the arrhythmias. Some people with irregular heart beats are at higher risk of having a stroke, and they so may benefit from a blood thinning medication to lower the risk of stroke.
Should you take aspirin?

Not everyone needs to take aspirin to prevent heart disease. Taking aspirin puts people at risk of bleeding, and only helps to prevent heart disease in certain people. If you have not had heart disease before, you should talk to your doctor before deciding to take aspirin. Aspirin is helpful in preventing heart disease only in certain people, such as those with existing heart disease, or people with diabetes who are at high risk for developing heart problems.

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