Heart & Vascular

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Coronary Artery Disease - How to prevent it, and what to do if you have it?
January 17, 2017

Coronary artery disease, which can cause shortness of breath, chest pain, and even a heart attack, results from the build-up of plaque within the walls of the vessels that supply blood to the heart. This condition causes your blood flow to be restricted — and therefore reduces the amount of oxygen delivered to the heart. Think of a roadway under construction, where the lanes are narrowed; the resulting constriction causes a slowdown in traffic. Plaque causes that narrowing in your arteries, and your blood responds the way cars do: it is forced to move sluggishly.

What causes plaque to build up? According to a Cardiologist at the Heart and Vascular Center of St. Luke’s University Health Network, plaque can accumulate from a variety of causes — some preventable, some not. “There are those who are medically predisposed to plaque build-up — a family history of certain diseases is not something you can control. However, there are other factors that you can certainly affect with lifestyle and dietary choices,” says a St. Luke’s Cardiologist.

Cholesterol — that word that often surfaces when talking about heart health — plays a large role. A routine blood test administered at the time of your annual physical can tell you where your cholesterol numbers are. Your intake of cholesterol depends on what you choose to eat, and there are two types of cholesterol to consider when making food choices. The “bad” cholesterol is low-density lipoprotein (LDL) — eating fatty meats, most cheeses, saturated fats like butter or bacon grease, trans fats like the ones found in crackers, and fast foods like fried chicken and burgers will increase your LDL levels.

On the other hand, says a St. Luke’s Cardiologist, high-density lipoprotein (HDL) is good for you: it actually works to remove plaque from your body, sort of scooping it out and sending it on to be processed in your liver and ultimately expelled. Foods that help tip the nutrition scale in your favor include olive oil and avocado oil, which are good sources of heart-healthy fats. Beans, lentils, peas, and whole grains contain soluble fiber, as does most fruit, which boosts your HDL and lowers your LDL. Nuts, such as almonds and walnuts, contain the right sort of fat, are high in fiber, and have one more benefit: they contain plant sterols, which block cholesterol from being absorbed in your body.

“Another good choice is to include more fatty fish when you plan your meals,” says a St. Luke’s Cardiologist. “Fish like salmon, mackerel, albacore tuna, and sardines contain omega-3 fatty acids, which work to lower your LDL and increase your HDL.”

Eating habits aside, what other changes can you make to prevent coronary artery disease? “One of the most important things to do is to stop smoking,” advises a St. Luke’s Cardiologist, another cardiologist at the Heart and Vascular Center. “The chemicals in cigarettes increase your blood pressure and increase the tendency for blood to clot — both very alarming factors in coronary artery disease.”

Staying at a healthy weight, and getting enough exercise, are also key to avoiding coronary artery disease. “When you weigh more than you should, and you’re a couch potato, you’re putting yourself at risk,” states a St. Luke’s Cardiologist. “Too much weight puts added stress on your heart, as it struggles to push the blood through a larger body than it is able to. And exercise is a natural way to increase your HDL. It also conditions your heart and muscles, so you can increase your overall endurance — without it, your body becomes more susceptible to illness.”

“These lifestyle choices work together,” a St. Luke’s Cardiologist observes. “When you make better food choices, you have more energy; when you have more energy, you can do more physical activity; when you do more physical activity, you have a better chance at losing weight. All these steps can lower your chances of having coronary artery disease.”

If you have already been diagnosed with coronary artery disease, what can you do to improve your health? “The same choices that prevent you from getting coronary artery disease can also be put to work to improve your heart health if you have the disease,” a St. Luke’s Cardiologist points out. “The right eating habits, physical activity, and stopping smoking go a long way to helping your heart.”

In addition to lifestyle changes, coronary artery disease patients have medical options for treatment when necessary. “Your cardiologist may prescribe certain medication to prevent blood clots from forming, or statins to control your cholesterol,” says a St. Luke’s Cardiologist. “Or you may need a procedure, such as a percutaneous coronary intervention (PCI), to help open your blocked artery.” Also known as angioplasty, PCI is a non-surgical procedure; a thin, flexible tube is threaded through a blood vessel to reach the blocked artery and push the plaque against its wall, allowing for greater blood flow.

During angioplasty, a St. Luke’s Cardiologist continues, sometimes a scaffolding-like structure called a stent is placed into the artery; the stent holds the artery open at the point of the obstruction. It works to prevent blockage for a longer period of time. “If further intervention is necessary, surgery, such as a coronary artery bypass, may be indicated,” says a St. Luke’s Cardiologist.

Of course, a cardiologist can best advise you on the actions you should take to either prevent or control coronary artery disease. Talk to your primary care doctor about your family history and the results of your blood test to determine if seeing a cardiologist is in your heart’s best interest.