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Online Wellness Community Natural Health and Anti-Aging News
Online Wellness Community Natural Health and Anti-Aging News

Arteriosclerosis Conventional Treatment and Care

Arteriosclerosis treatment and care – conventional western medicine standard of care

Your doctor can determine your risk for heart disease by conducting some tests. Blood tests can show high levels of cholesterol, homocysteine, and blood clotting factors. A stress test (also known as an exercise tolerance test) monitors your heart rate and blood pressure while you walk on a treadmill or ride a stationary bicycle. An electrocardiogram (ECG) is used during a stress test to detect abnormal heart rhythms, scar tissue in the heart muscle from a prior heart attack, and areas of decreased blood flow to the heart. Imaging techniques used during a stress test (such as an ultrasound) can pinpoint areas where blood flow to the heart may be decreased. An angiogram (or angiography), where your doctor injects a dye into your arteries and then performs a chest x-ray, can reveal areas of damage and plaque buildup.

Cholesterol-Lowering Drugs

If, after making adjustments to your diet and exercise habits, your “bad” LDL cholesterol remains high, your doctor may prescribe medications to lower it. If your cholesterol is extremely high (more than 200 mg/dL), you may start drug therapy at the same time you make lifestyle changes. Drugs commonly used to treat high cholesterol include:

  • Statins — These are usually the drugs of choice as they are easy to take and have few interactions with other drugs. Side effects can include myositis (inflammation of the muscles), joint pain, stomach upset, and liver damage. People who are pregnant or have liver disease should not take statins. Statins include:
    • Lovastatin (Mevachor)
    • Pravastatin (Pravachol)
    • Rosuvastatin (Crestor)
    • Simvastatin (Zocor)
    • Atorvastatin (Lipitor)
    • Fluvastatin (Lescor)
  • Niacin (nicotinic acid) — In prescription form, niacin is sometimes used to lower LDL cholesterol. It can be more effective in raising HDL cholesterol than other medications. Side effects may include redness or flushing of the skin (which can be reduced by taking aspirin 30 minutes before the niacin), stomach upset (which usually subsides in a few weeks), headache, dizziness, blurred vision, and liver damage. Dietary supplements of niacin should not be used instead of prescription niacin, as it can cause side effects. Only take niacin for high cholesterol with your doctor’s supervision.
  • Bile acid sequestrants — These are used to treat high levels of LDL. Common side effects include bloating, constipation, heartburn, and elevated triglycerides. People who have high levels of triglycerides (fats in the blood) should not take bile acid sequestrants. These drugs include:
    • Cholestyramine (Prevalite, Questran)
    • Colestipol (Colestid)
    • Colesevelam (WelChol)
  • Cholesterol absorption inhibitors — The medication ezetimibe (Zetia) limits how much LDL cholesterol can be absorbed in the small intestine. Side effects include headaches, nausea, muscle weakness. Ezetimibe is combined with simvastatin in the drug Vytorin.
  • Fibric acid derivatives — These medicines are effective at lowering triglyceride levels, and moderately effective at lowering LDL. They are used to treat high triglycerides and low HDL in people who cannot take niacin. Side effects include myositis, stomach upset, sun sensitivity, gallstones, irregular heartbeat, and liver damage.
    • Gemfibrozil (Lopid)
    • Fenofibrate (Tricor, Lofibra)

If you do not respond to one class of drugs, you doctor may use a combination of drugs from two classes.

Blood Pressure-Lowering Drugs

If, after making adjustments to your diet and exercise habits, your blood pressure remains high, your doctor may prescribe medications to lower it. Among the drugs used to lower blood pressure are:

  • Beta blockers — slow down the heart rate (reducing the workload on the heart) and reduce stress hormones in the body (which allows blood vessels to relax). Beta blockers alone don’t work as well in African-Americans, but are effective when combined with a thiazide diuretic. Beta blockers include
    • Atenolol (Tenormin)
    • Bisoprolol (Zebeta)
    • Metoprolol (Lopressor, Toprol XL)
    • Nadolol (Corgard)
    • Timolol (Blocadren)
    • Nebivolol (Bystolic)
  • Angiotensin-converting enzyme (ACE) inhibitors — block the chemical angiotensin from forming in the body, helping prevent blood vessels from narrowing. As blood vessels relax, blood pressure is lowered. Like beta blockers, ACE inhibitors along don’t work as well in African-Americans, but are effective when combined with a thiazide diuretic.ACE inhibitors include:
    • Captopril (Capoten)
    • Benazepril (Lotensin)
    • Enalapril (Vasotec)
    • Lisinopril (Prinivil, Zestril)
    • Fosinopril (Monopril)
    • Ramipril (Altace)
    • Perindopril (Aceon)
    • Quinapril (Accupril)
    • Moexipril (Univasc)
    • Trandolapril (Mavik)
  • Calcium-channel blockers — relax blood vessels and lower blood pressure by blocking calcium from entering heart cells and arteries. Side effects may include constipation, nausea, and headache. Grapefruit juice interacts with some calcium-channel blockers, so avoid it if you take these drugs. Calcium-channel blockers include:
    • Amlodipine (Norvasc)
    • Bepridil (Vascor)
    • Diltiazem (Cardizem)
    • Felodipine (Plendil)
    • Nifedipine (Adalat, Procardia)
    • Nicardipine (Cardene)
    • Verapamil (Calan, Isoptin)
  • Angiotensin II receptor blockers (ARBs) — block the effects of the chemical angiotensin in the body, lowering blood pressure. ARBs are sometimes used when a person cannot take ACE inhibitors. These drugs include:
    • Candesartan (Atacand)
    • Eprosartan (Tevetan)
    • Irbesartan (Avapro)
    • Losartan (Cozaar)
    • Telmisartan (Mycardis)
    • Valsartan (Diovan)
  • Diuretics — help the kidneys get rid of sodium and water from the body. This decreases the volume of blood in the body and lowers blood pressure. There are three types of diuretics: thiazide, loop, and potassium-sparing.
    • Thiazide diuretics — may lower potassium levels and may increase cholesterol and blood sugar. Hydrocholorothiazide is the most common of these.
    • Loop diuretics — also tend to lower potassium levels. Furosemide (Lasix) and bumetanide (Bumex) are loop diuretics.
    • Potassium-sparing diuretics — do not lower potassium. Amiloride (Midamor) and triamterene (Maxzidel) are in this class.

Sometimes drugs from these classes may be combined.

Blood-Thinning Drugs

Blood-thinning drugs — antiplatelet agents and anticoagulants — are used to keep blood clots from forming.

  • Aspirin — reduces risk of transient ischemic attack (TIA), stroke, and heart attacks
  • Ticlodipine — for people who cannot take aspirin (due to allergies, for example) or do not improve from aspirin; has more side effects than aspirin
  • Dipyridamole — not as effective as aspirin when used alone but may be used in combination with aspirin or warfarin (another blood thinner)
  • Clopidogrel (Plavix) — reduces risk of heart attacks
  • Glycoprotein IIb/IIIa receptor agonists (such as abciximab, eptifibatide, lamifiban, and tirofiban) — used when awaiting or just following an angioplasty
  • Heparin — anticoagulant; given by injection
  • Warfarin (Coumadin) — often used after a heart attack

Surgery and Other Procedures

Several different procedures (surgical and non-surgical) may be performed depending upon which arteries are narrowed and how much they are blocked.

Non-surgical techniques

  • Angioplasty — used to widen narrowed arteries. A surgeon inserts a catheter with a deflated balloon into the narrowed part of the artery. The balloon is inflated, widening the blood vessel so blood can flow more easily. The balloon is then deflated, and the catheter is removed. A permanent stent (wire mesh) may be put in to hold the artery open and improve blood flow.
  • Atherectomy — a procedure to remove plaque from the arteries. It uses a laser catheter or a rotating shaver.

Surgical Procedures

  • Bypass surgery — A surgeon uses a blood vessel from another part of your body or an artificial tube to reroute blood around clogged arteries.
  • Minimally invasive bypass surgery — uses a small incision rather than the broad opening in the chest wall created during regular bypass surgery.
  • Endarterectomy — used to remove plaque in the carotid (neck) or peripheral arteries.

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