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The goal of lifestyle changes is to prevent further build up of plaque and decrease damage to your blood vessels. Some steps may even help reduce the amount of plaque in your blood vessels. These changes will also reduce your risk of heart attack and stroke.

Dietary Changes

If you are not on a special diet to manage other conditions, your doctor may recommend dietary changes.

Diets that are high in saturated fat and cholesterol increase your risk of CAD. Saturated fat and cholesterol are found in animal products, full-fat dairy products, lard, and palm and coconut oils, among other foods. These foods contribute to build up of plaque.

A dietitian can help you reduce saturated fats and cholesterol in your diet and teach you how to make healthier substitutions. Good dietary choices include fresh fruits and vegetable, as well as lean meats and fish—particularly fish rich in omega-3 fatty acids, such as salmon.

Decreasing low-density lipoprotein (LDL) cholesterol intake while increasing high-density lipoprotein (HDL) cholesterol intake may improve blood flow to the heart by reducing the amount of plaque in your arteries. Limiting fat and cholesterol in your diet can also help you lose weight.

Exercise Regularly

Do not begin any exercise program without consulting your doctor.

Regular aerobic training can help increase your physical abilities and quality of life. You should aim to exercise for at least 30 minutes per day on most days of the week. Begin slowly and work your way to this goal. Depending on the symptoms and severity of your condition, your doctor may have you do an exercise test before starting a program.

Quit Smoking

Smoking damages your blood vessels and lung tissue, reduces the amount of oxygen in your blood, and forces your heart to beat faster. Discuss with your doctor the best way to quit smoking. Remember that secondhand smoke is also harmful. Make sure you are not exposed to cigarette smoke if at all possible. Not smoking improves blood flow by relaxing constricted blood vessels.

Reduce or Avoid Excess Weight

Excess weight strains the heart muscle and is associated with increased risk of atherosclerosis. If you are overweight, talk with a dietitian who can help you with portion control and meal planning. To achieve your goal weight, you should also participate in regular exercise most days of the week.

If you are struggling to lose weight, talk to your doctor about your options and what your ideal weight range may be.

Decrease or Discontinue Alcohol Consumption

Excess alcohol increases triglyceride levels in the blood, which contribute to atherosclerosis and heart arrhythmias. Alcohol also may react with certain medications.

Reduction or elimination of alcohol can help improve symptoms associated with angina. Moderate drinking is considered two drinks per day for men and one drink per day for women. Small amounts of alcohol in this range may have beneficial effects such as raising your HDL cholesterol.

Manage Chronic Conditions

It is just as important to follow any treatment plans for other chronic conditions you may have. Managing chronic conditions will help with your treatment of CAD. This includes:

Control Blood Glucose Levels

People who have diabetes may reduce their risk of heart attack or other cardiac events if they maintain their blood glucose near normal levels. There are many other proven health benefits to maintaining tight control of blood glucose. If you have diabetes, talk to your doctor about ways to keep your blood glucose in a healthy range.

Maintain Normal Blood Pressure

High blood pressure is one of the most critical risk factors CAD. High blood pressure causes the heart muscle to work harder to pump blood through narrowed blood vessels. The increased strain on the heart can also lead to heart failure. Maintaining a healthy blood pressure involves weight management, salt reduction, exercise, and stress management. If none of these methods work, talk to your doctor about blood pressure medications and home monitoring.

Take Prescribed Medications

Take any medications your doctor has prescribed, such as statins for lipid disorders. Use medications as recommended by your doctor, or according to the instructions provided. Talk with your doctor if you have questions about usage or side effects.

Communication

Maintain regular communication with your healthcare team, adhere to your treatment plan, and go to any recommended appointments. Your needs may change over time. Regular contact with your healthcare team will help you stay on top of any changes.

Identifying and Managing Depression

People who are depressed are less likely to adhere to their treatment plans for other chronic conditions. This contributes to an increased risk of complications associated with CAD.

Other Management
  • Sexual activity—It is normal for you or your partner to feel concerned about whether it is safe for you to resume sexual activity. In general, people who have CAD that is stable and properly treated can engage in sexual activity. To find out what is safe for you, make an appointment to discuss this issue with your doctor.
  • CounselingDepression is common with many cardiovascular disorders. If you are feeling depressed or are having trouble managing your CAD, ask your doctor about counseling. Counselors can help you navigate challenges of living with a chronic condition. It also may be beneficial to join a support group so you can interact with others who have CAD. They offer an environment of encouragement and support that will help you adjust and adhere to your treatment.
  • Cardiac rehabilitation—Provides supervised education and counseling to increase exercise, manage symptoms, and reduce the risk of further heart-related conditions.

Be an active participant in your care. Talk to your team about symptoms or treatments that you are having difficulty with. Other treatments options may be available to help you better manage your CAD.

When to Contact Your Doctor

Contact your doctor if you notice changes in any of these symptoms:

  • Chest pain
  • Usual patterns of angina
  • Shortness of breath, especially when out of proportion to exercise or exertion
  • Fatigue

References:

Coronary artery disease (CAD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 16, 2013. Accessed January 28, 2014.

How is coronary heart disease treated? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/cad/treatment.html. Updated August 23, 2012. Accessed January 28, 2014.

Living with coronary heart disease. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/cad/livingwith.html. Updated August 23, 2012. Accessed January 28, 2014.

Management of angina. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 2, 2013. Accessed January 28, 2014.

3/6/2013 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Marti-Carvajal AJ, Lathyris D, et al. Homocysteine lowering interventions for preventing cardiovascular events. Cochrane Database Syst Rev. 2013;1:CD006612.



Last reviewed September 2013 by Michael J. Fucci, DO

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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