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- Statins: Statins block an enzyme the body needs to produce cholesterol which helps to lower LDL ("bad") cholesterol and thereby reduces total blood cholesterol levels. This lowers the risk of heart attack and stroke in people who are increased risk of either.
Common types of statins are:
- ACE inhibitors: ACE (angiotensin-converting enzyme) inhibitors interfere with the formation of angiotensin II, a hormone that narrows blood vessels. This helps lower blood pressure and reduces the workload on the heart, which lowers the chance of a heart attack.
Common types of ACE inhibitors include:
- Ranolazine (brand name Ranexa): Ranolazine is used to treat chronic stable angina. It works by improving blood flow to help the heart work more efficiently. It can be used alone or with other angina medications, such as calcium channel blockers, beta blockers or nitroglycerin. Unlike some other angina medications, ranolazine can be used if you're taking oral erectile dysfunction medications.
When lifestyle changes and medications aren't enough to control stable angina or if you have unstable angina, medical procedures including surgery are often used. These include:
- Angioplasty and stenting: Angioplasty opens blocked or narrowed coronary arteries and can improve blood flow to the heart, relieve chest pain and possibly prevent a heart attack. During angioplasty a thin tube with a balloon on the end is threaded through a blood vessel to the narrowed or blocked artery. Once in place, the balloon is inflated to push the fatty deposits (plaque) up against the artery wall. This widens the artery and restores blood flow. Sometimes a small mesh tube called a stent is placed in the artery to help keep it open after the procedure.
- Coronary artery bypass graft surgery (CABG): Coronary artery bypass graft surgery (CABG) helps to improve the blood flow to the heart in people with heart disease. In a coronary artery bypass, a healthy vein or artery from another part of the body is connected to the blocked artery, creating a new pathway around the blocked part of the artery and restoring blood supply to the heart muscle. Bypass surgery can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.
Cardiac rehab is a medically supervised program that focuses on improving general heart health and reducing the risk of future heart problems. It is often recommended for people with angina or after a person has had angioplasty, coronary artery surgery or a heart attack. The program has two parts: exercise training to improve cardiovascular fitness and education and counseling to help you understand your heart problems and make lifestyle changes that reduce your risk of heart disease and heart attack.
The cardiac rehab team may include doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists.
Katherine Solem is a health writer and editor living in San Francisco.