Coronary artery disease is a long-term heart condition affecting millions in the US and worldwide. Coronary artery disease is more common among adults aged 60 and over. Still, people under 40 can also develop coronary artery disease if they smoke or have a family history of heart disease. Fortunately, medications and a healthy lifestyle can help manage symptoms and prevent complications of heart attacks.

What is the role of coronary arteries?

Coronary arteries supply the heart with blood that carries oxygen to the body’s organs. The heart needs oxygen to pump and keep the body alive.

What is coronary artery disease?

When fat accumulates in the coronary arteries, it creates blockages that impede blood flow to the heart, leading to atherosclerosis.

What causes coronary artery disease?

Coronary artery disease develops due to modifiable and non-modifiable risk factors. Minimizing modifiable risk factors is crucial in reducing the incidence of coronary artery disease. These are the leading causes of coronary artery disease:

• Age: Coronary artery disease is most prevalent in those aged 75 to 84, followed by the 45 to 65 age group.

• Gender: Coronary artery disease is more prevalent in men than women. However, at menopause, women face a higher risk due to decreased estrogen levels.

• Race: The genetic factor is non-modifiable. For instance, Black individuals are more prone to developing coronary artery disease than White individuals.

• Family history: You may have a higher risk of coronary artery disease if it runs in your family.

• Smoking: Tobacco usage can block blood vessels, cause blood clots to form, and lead to atherosclerosis.

• Lipid levels: Consuming foods high in saturated fat can lead to abnormal lipid levels, known as dyslipidemia. High cholesterol levels and low-density lipoprotein (LDL) are associated with coronary artery disease. In contrast, elevated high-density lipoprotein (HDL) levels can decrease the risk of such a disease.

• Obesity: High body fat increases the risk of coronary artery disease. In obesity, a body mass index (BMI) of 30 kg/m² or more, or an increased waist-to-hip ratio, puts you at a higher risk of developing coronary artery disease.

• Hypertension: Older adults with high blood pressure often develop atherosclerosis. Fortunately, hypertension is a modifiable risk factor. Patients with coronary artery disease should aim for blood pressure below 140/90 mm Hg.

• Diabetes: High blood glucose increases the risk of coronary artery disease. Management of blood sugar can decrease the risk of coronary artery disease. Patients should maintain glycemic control (HbA1c levels below 7%) to reduce the risk of coronary artery disease.

What are the symptoms of coronary artery disease?

Coronary artery disease may not show symptoms until a heart attack occurs. Maintaining a healthy diet and active lifestyle is crucial.

If you have coronary artery disease, you may experience symptoms like:

• Chest pain (angina) – chest pressure radiating into the jaw, neck, and left arm.
• Fast heart rate (palpation)
• Nausea/vomiting
• Shortness of breath
• Dizziness/fatigue
• Swelling of lower extremities
• Limited exercise ability

How is coronary artery disease treated?

Treating coronary artery disease requires a combination of pharmaceutical drugs and modifications to one’s lifestyle.

• Pharmaceutical Drugs

Pharmaceutical drugs can alleviate chest pain and reduce the risk of heart failure. Your physician may prescribe these medications:

• Aspirin: helps stop the formation of clots in the blood vessels.

• Statins: Lower cholesterol levels and prevent the formation of fat in the coronary arteries.

• Beta-blockers: Lower the heart rate and blood pressure. Reduce strain on the heart and relieve chest pain.

• Calcium-channel blockers: Reduce blood pressure within the heart chamber and alleviate chest pain.

• Nitrates: Dilates the blood vessels to alleviate chest pain symptoms.

• Lifestyle Modifications

A healthy lifestyle can lower the risk of coronary artery disease. Adopting healthy habits can improve patients’ quality of life. Here are some lifestyle changes you can make:

• Diet: Eat plenty of fruits and vegetables; ensure half your plate is filled with raw or cooked vegetables. Consume high-fiber sources like whole grains, legumes, and nuts. Limit your daily salt intake to 2400 mg.

• Omega-3 fatty acids: To prevent blood clots and reduce the risk of coronary artery disease, consuming at least two portions of fish per week is recommended. Alternatively, you can follow the Atlantic diet based on a high fish intake. Omega-3 can also be found in flaxseed, canola, and soybean oil. If you cannot get enough fish in your diet, you may consider fish oil supplements only after consulting with your physician.

• Physical activity: Aim to moderate-intensity exercise for 30 minutes, 5 days weekly. Choose an activity such as walking, jogging, cycling, or swimming.

• Weight loss: Losing weight can be beneficial for your health. If you are currently overweight, aiming to lose 10-15% of your body weight is recommended. If you are obese, achieve a BMI below 25 kg/m^2. BMI is calculated by dividing your weight in kilograms by the square of your height in meters. Exercising regularly and maintaining a healthy diet is vital to lose body fat.

• Quit smoking: Make a wise decision for your health and quit smoking. Nicotine replacement therapy, such as gum or patches, can help remove nicotine from your body.

• Limit alcohol: consuming high amounts of alcohol can lead to elevated blood pressure. Limit alcohol consumption to 2-3 drinks per day.