Coronary artery disease
What is it?
Coronary artery disease is also called "CAD." CAD is when the arteries in your heart narrow or become blocked. CAD may cause angina (chest pain), a heart attack, or congestive heart failure. CAD is one of the leading causes of death in America. The chance of dying from CAD today is much less than 40 years ago.
CAD is more common in older people. Both men and women can get CAD. CAD is not as common in women before menopause (change of life). You may be more likely to get CAD if you have family members who have it.
CAD is caused by cholesterol (ko-LES-ter-all) and blood clots that collect inside your arteries (blood vessels). When your arteries get narrow or blocked, they cannot get oxygen to your heart muscle. This part of the heart muscle is damaged or dies.
Smoking, high blood pressure, high cholesterol, eating unhealthy foods, being overweight, and not exercising may cause CAD.
Signs and Symptoms:
You may not have any symptoms of CAD. The most common symptom of CAD is angina pectoris. Angina (AN-gin-uh) pectoris (pek-TOR-is) is chest pain that happens when your heart does not get enough oxygen. The pain is usually caused by a blockage or spasm of the arteries in the heart. You could have a heart attack if your angina is not treated. You may have stable or unstable angina.
Stable Angina: The most common symptom of stable angina is chest pain. The pain may start below the breast bone. It may feel crushing, tight, or heavy. It may move to the neck, jaw, shoulders, back, or inner arms. You may have pain under the breast bone that feels like indigestion (burning). The pain often starts slowly and may only last a few minutes. Stable angina may be caused by cold air or getting upset. Physical work, like walking or snow shoveling, may also cause pain. Angina may feel different to each person. Rest or medicine usually makes stable angina go away.
Unstable Angina: Unstable angina is chest pain that happens more often or with less activity than before. Unstable angina starts while you are resting or exercising. After resting, you may still have pain. Unstable angina is a warning that you may be at risk for a heart attack.
Exercise when your caregiver says it is OK. If you smoke, quit. Lose weight if you are overweight. Eat low fat, low salt, high fiber foods, such as fruit, vegetables, and whole grains. Learn how to control stress.
Tests may be done to learn if you have blockage in your heart arteries. You may need to take medicine to decrease cholesterol. You may need to go into the hospital for tests and treatment. Surgery may be needed if tests show you have serious blockage of your heart arteries.
- A vegetarian diet decreases heart disease risk.
- Fiber in your diet decreases cholesterol and heart disease risk.
- Avoid saturated fats that increase heart disease risk.
- Use olive oil in your cooking as it may decrease heart disease risk.
- Eating onion, garlic, and soy may improve heart disease and high cholesterol.
Herbs and Supplements:
Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.
- Artichoke (Cynarae folium) extract may be helpful for high cholesterol and has been studied in people.
- Evening primrose (Oenothera biennis) may be helpful for high cholesterol and has been studied in people.
- Fenugreek (Trigonella foenum - graecum) may be helpful for high cholesterol and has been studied in people.
- Garlic (Allium sativum) may decrease cholesterol. Fresh garlic is likely more helpful in lowering cholesterol than garlic pills.
- Guggul (Commiphora mukul) may help in lowering cholesterol. Read the label on the bottle carefully. Be sure the label says each pill contains 4% gugulsterones.
- Arginine may be helpful for coronary artery disease and has been studied in people.
- Calcium is helpful for high cholesterol and has been studied in people.
- Chitosan may be helpful for high cholesterol and has been studied in people.
- Chromium may be helpful for high cholesterol and has been studied in people.
- Fish oil (DHA, EPA) is helpful for high cholesterol and has been studied in people.
- Gamma oryzanol may be helpful for high cholesterol and has been studied in people.
- Guar gum may be helpful for high cholesterol and has been studied in people. It works best when used with cholesterol-lowering medicine.
- Lecithin may be helpful for high cholesterol and has been studied in people.
- Niacin lowers cholesterol and has been studied in people.
- Plant sterols and stanols (Beta-sitosterol) may be helpful for high cholesterol and has been studied in people.
- Policosanol may be helpful for high cholesterol and has been studied in people.
- Tocotrienols may be helpful for coronary artery disease and has been studied in people.
- Vitamin B5 (pantothenic acid) may be helpful for high cholesterol and has been studied in people.
- Vitamin C may be helpful for coronary artery disease and has been studied in people.
- Vitamin E may be helpful for high cholesterol and has been studied in people.
- Acupuncture may help coronary artery disease.
- Relaxation techniques and meditation may help coronary artery disease.
- Yoga may help coronary artery disease.
SEEK CARE IMMEDIATELY IF:
Call 911 or 0 (operator) if you have the following signs or symptoms that may mean you are having a heart attack. Do not drive yourself to the hospital.
- Crushing chest pressure or pain in the center of the chest that spreads to your shoulders, arms, jaw, neck, or back. The pain may be like a burning feeling that feels like heartburn. Chest pain may last more than a few minutes or the pain may go away and come back.
- Cold sweats or sweating.
- Feeling short of breath.
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
1. Agarwal V, Gupta B, Singhal U et al: Examination stress: changes in serum cholesterol, triglycerides and total lipids. Indian J Physiol Pharmacol 1997; 41(4):404-408.
2. Anderson JW, Johnstone BM & Cook-Newell ME: Meta-analysis of the effects of soy protein intake on serum lipids . N Engl J Med 1995; 3333:276-282.
3. Anderson JW: Dietary fiber, lipids and atherosclerosis. Am J Cardiol 1987; 60(12):17G-22G.
4. Aronov DM, Keenan JM, Achmedzhanov NM et al: Clinical trial of wax-matrix sustained-release niacin in a Russian population with hypercholesterolemia. Arch Fam Med 1996; 5(10):567-575.
5. Batista J, Stusser R, Saez F et al: Effect of policosanol on hyperlipidemia and coronary heart disease in middle-aged patients. A 14-month pilot study. Int J Clin Pharmacol Ther 1996; 34(3):134-137.
6. Bell L, Halstenson CE, Halstenson CJ et al: Cholesterol-lowering effects of calcium carbonate in patients with mild to moderate hypercholesterolemia. Arch Intern Med 1992; 152(12):2441-2444.
7. Blanchard EB & Miller ST: Psychological treatment of cardiovascular disease. Arch Gen Psychiatry 1977; 34(12):1402-1413.
8. Bordia A, Verma SK & Srivastava KC: Effect of ginger (Zingiber officinale rosc.) and fenugreek (Trigonella foenumgraecum L) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids 1997; 56(5):379-384.
9. Cattin L, DaCol PG, Fonda M et al: Treatment of hypercholesterolemia with pantithine (b5) and fenofibrate: an open randomized study on 43 subjects. Curr Ther Res 1985; 38(3):386-395.
10. Chao DM, Shen LL, Tjen-A-Looi S et al: Naloxone reverses inhibitory effect of electroacupuncture on sympathetic cardiovascular reflex responses. Am J Physiol 1999; 276(6 pt 2):H2127-H2134.
11. Denke MA, Fox MM & Schulte MC: Short-term dietary calcium fortification increases fecal saturated fat content and reduces serum lipids in men. J Nutr 1993; 123(6):1047-1053.
12. FDA: FDA approves new health claim for soy protein and coronary heart disease. FDA Talk Paper October 20, 1999. available http://www.cfsan.fda.gov/~lrd/tpsoypr2.html (cited 8/18/03).
13. Gardner CD, Chatterjee LM & Carlson JJ: The effect of a garlic preparation on plasma lipid levels in moderately hypercholesterolemic adults. Atherosclerosis 2001; 154(1):213-220.
14. Grajeta H: Effect of amaranth and oat bran on blood serum and liver lipids in rats depending on the kind of dietary fats. Nahrung 1999; 43(2):114-117.
15. Guivernau M, Meza N, Barja P et al: Clinical and experimental study on the longer-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacycline production. Prostaglandins Leukot Essent Fatty Acids 1994; 51:311-316.
16. Guyton JR: Effect of niacin on atherosclerotic cardiovascular disease. Am J Cardiol 1998: 82(12A):18U-23U.
17. Knekt P, Jarvinen R, Reunanen A et al: Flavonoid intake and coronary mortality in Finland: a cohort study. BMJ 1996; 312(7029):478-481.
18. Knopp RH, Superko HR, Davidson M et al: Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Am J Prev Med 1999; 17(1):18-23.
19. Koscienlny J, Klüßendorf D, Latza R, et al. The anti-atherosclerotic effect of Allium sativum. Atherosclerosis 1999; 144:237-249.
20. Lee NA & Reasner CA: Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care 1994; 17(12):1449-1452.
21. Lerman A, Burnett JC Jr, Higano ST et al: Long-term L-arginine supplementation improves small-vessel coronary endothelial function in humans. Circulation 1998; 97:2123-2128.
22. Levine M, Conry-Cantilena C, Wang Y et al: Vitamin C pharmacokinetics in healthy volunteers: evidence for a recommended dietary allowance. Proc Natl Acad Sci USA 1996; 93(8):3704-3709.
23. Mahajan AS, Reddy KS & Sachdeva U: Lipid profile of coronary risk subjects following yogic lifestyle intervention. Indian Heart J 1999; 51(1):37-40.
24. Massaro M, Carluccio MA & DeCaterina R: Direct vascular antiatherogenic effects of oleic acid: a clue to the cardioprotective effects of the Mediterranean diet. Cardiologia 1999; 44(6):507-513.
25. Nigon F, Serfaty-Lacrosniere C, Beucler I et al: Plant sterol-enriched margarine lowers plasma LDL in hyperlipidemic subjects with low cholesterol intake: effect of fibrate treatment. Clin Chem Lab Med 2001; 39(7):634-640.
26. Nikkila M: Influence of fish oil on blood lipids in coronary artery disease. Eur J Clin Nutr 1991; 45:209-213.
27. Oliver MF: Diet and coronary heart disease. Hum Nutr Clin Nutr 1982; 36(6):413-427.
28. Ornish D, Scherwitz LW, Billings JH et al: Intensive lifestyle changes for reversal of coronary heart disease. JAMA 1998; 280(23):2001-2007.
29. Roeback JR Jr, Hla KM, Chambless LE et al: Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers: a randomized, controlled trial. Ann Intern Med 1991; 115(12):917-924.
30. Salonen RM, Nyyssonen K, Kaikkonen J et al: Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression. Circulation 2003; 107:947-953.
31. Schaefer EJ & Levy RI: Pathogenesis and management of lipoprotein disorders. N Engl J Med 1985; 312:1300-1310.
32. Singh RB, Niaz MA & Ghosh S: Hypolipidemic and antioxidant effects of commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994; 8(4):659-664.
33. Stevinson C, Pittler MH & Ernst E: Garlic for treating hypercholesterolemia. A meta-analysis of randomized clinical trials. Ann Intern Med 2000; 133(6):420-429.
34. Tai TS, Sheu WHH, Lee WJ et al: Effect of chitosan on plasma lipoprotein concentrations in type 2 diabetic subjects with hypercholesterolemia. Diabetes Care 2000; 23(11):1703-1704.
35. Todd PA, Benfield P & Goa KL: Guar gum: a review of its pharmacological properties and use as a dietary adjunct in hypercholesterolemia. Drugs 1990; 39(6):917-928.
36. Tomeo AC, Geller M, Watkins TR et al: Antioxidant effects of tocotrienols in patients with hyperlipidemia and carotid stenosis. Lipids 1995; 30(12):1179-1183.
37. Virtamo J, Rapola JM, Ripatti S et al: Effect of vitamin E and beta-carotene on the incidence of primary nonfatal myocardial infarction and fatal coronary heart disease. Arch Intern Med 1998; 158(6):668-675.
38. Wojcicki J, Pawlik A, Samochowiec L et al: Clinical evaluation of lecithin as a lipid-lowering agent. Phytother Res 1995; 9:597-599.
39. Wong WW, Smith EO, Stuff JE et al: Cholesterol-lowering effect of soy protein in normocholesterolemic and hypercholesterolemic men (abstract). Am J Clin Nutr 1998; 68(6 suppl):S1385-S1389.
40. Yoshino G, Kazumi T, Amano M et al: Effects of gamma oryzanol on hyperlipidemic subjects. Curr Ther Res 1989a; 45(4):543-552.
Last Updated: 1/27/2017