Living with Coronary Heart Disease (CHD) can bring anxiety and uncertainty, especially when dealing with symptoms like chest pain (angina) or shortness of breath. CHD occurs when the major blood vessels supplying the heart become damaged and narrowed by plaque buildup, a process called atherosclerosis. This limits the essential supply of oxygen-rich blood to the heart muscle, affecting your energy, activity level, and overall comfort.

Treatment is vital to improve heart function, relieve painful symptoms, and, most importantly, prevent life-threatening events like heart attacks. While the underlying plaque cannot be completely removed with medication, drug therapies are highly effective at controlling related risk factors and slowing the disease’s progression. Because the severity of blockages and the presence of other conditions (like high blood pressure or diabetes) vary, treatment plans are always highly customized to the individual’s needs (American Heart Association, 2024).

Overview of treatment options for Coronary Heart Disease

The overall treatment strategy for CHD is aggressive and multi-faceted, aiming to target both the symptoms and the underlying cause of the plaque buildup. The main goals are to relieve angina pain, control cardiovascular risk factors (cholesterol, blood pressure), and minimize the risk of blood clots forming on the plaques.

For all patients, treatment begins with significant lifestyle changes, including dietary modification and increased physical activity. However, medication is the necessary foundation for most patients with established CHD. Drug classes are used long-term to keep the disease stable. Procedures, such as angioplasty (stenting) or bypass surgery, are reserved for cases where blood flow is critically blocked and medication alone cannot manage symptoms or risk.

Medications used for Coronary Heart Disease

Medications for CHD are organized into groups that address specific components of the disease:

• Cholesterol-Lowering Drugs: Statins are the primary medication class used. Examples include simvastatin and atorvastatin. These are critical not just for lowering LDL (“bad”) cholesterol but also for stabilizing the plaque inside artery walls, reducing the risk of rupture.
• Antiplatelet Drugs: These drugs reduce the likelihood of harmful blood clots forming. Aspirin is commonly prescribed for most CHD patients. For higher-risk cases, a second agent, such as clopidogrel, may be added temporarily.
• Blood Pressure-Lowering Drugs: Beta-blockers (e.g., metoprolol) and ACE inhibitors (e.g., lisinopril) are widely used. Beta-blockers help the heart beat slower and with less force. ACE inhibitors relax blood vessels and lower pressure.
• Angina Relief: Nitrates are used to relieve chest pain. Short-acting nitrates (like nitroglycerin) work quickly to relax arteries when angina strikes. Long-acting nitrates help prevent pain throughout the day.

Studies show that consistent adherence to cholesterol-lowering and blood pressure medications provides the greatest reduction in heart attack and stroke risk over time (National Heart, Lung, and Blood Institute, 2022).

How these medications work

Statins lower cholesterol production and circulation, reducing plaque growth. Crucially, they also stabilize existing plaque through anti-inflammatory effects, preventing rupture and clotting.

Antiplatelet drugs, like Aspirin, prevent blood platelets from sticking together to form clots, a common cause of heart attacks, by inhibiting a specific chemical signal.

Blood pressure medications lessen the heart’s workload. Beta-blockers reduce heart rate and force by blocking adrenaline. ACE inhibitors ease blood flow by preventing the production of vessel-narrowing hormones. Nitrates immediately increase blood flow to the heart muscle by rapidly relaxing and widening blood vessels.

Side effects and safety considerations

CHD medications require close monitoring. Statins can cause muscle aches or liver problems, necessitating periodic blood tests. Antiplatelet drugs increase bleeding risk; patients must report unusual bruising or blood in the stool.

Beta-blockers may cause fatigue, slow heart rate, or cold extremities. ACE inhibitors can cause a dry cough. Nitroglycerin often causes headaches or dizziness from sudden blood pressure drops.

Patients with CHD should immediately call 911 for new or worsening chest pain, crushing chest pressure, or pain radiating to the jaw or arm, as these signal an acute heart attack. Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

1. American Heart Association. https://www.heart.org
2. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov
3. Mayo Clinic. https://www.mayoclinic.org
4. MedlinePlus. https://medlineplus.gov