Heart Disease Treatment: Medication, Lifestyle Changes, and More

Heart disease treatment aims to reduce the risk of severe cardiac events, such as a heart attack or stroke, as well as relieve symptoms like chest pain and reduced exercise capacity. Treating heart disease can involve a range of approaches, from lifestyle changes to long-term medications and surgery.

The term “heart disease” covers a variety of different conditions, such as coronary artery disease, heart failure, and arrhythmia, which can all differ in severity and require different solutions.

Your doctor will devise the treatment plan that’s best for your needs. Reducing your risk of complications may also involve keeping other conditions like diabetes or high cholesterol in check. Follow directions carefully and talk to your doctor before starting or combining treatments.

A doctor may prescribe medication to treat heart disease long before you experience symptoms, says David Taylor Majure, MD, MPH, medical director of the heart transplant service at NewYork Presbyterian/Weill Cornell Medical Center.

“You’re trying to prevent something like heart failure or stroke in the future,” says Dr. Majure. “But 10 years before that event happens, [you] might feel okay.”

A doctor’s role in prescribing heart disease medication involves helping people understand the end goal, says Majure. Some people may experience side effects with these medications, so understanding how they work is key. “It’s not just bringing that blood pressure number down. It’s trying to prevent something in the future,” says Majure.

There are many types of medication that are prescribed to treat and prevent heart disease:

Anticoagulants

Anticoagulants are blood-thinning medications that help prevent harmful blood clots from forming or growing. Doctors often prescribe these medications to prevent a person’s first stroke, repeated strokes after a first stroke, or a heart attack.

• apixaban (Eliquis)
• dabigatran (Pradaxa)
• edoxaban (Savaysa)
• heparin (various)
• rivaroxaban (Xarelto)
• warfarin (Coumadin)

Angiotensin-Converting Enzyme Inhibitors

• benazepril (Lotensin)
• enalapril (Vasotec)
• fosinopril (Monopril)
• lisinopril (Prinivil, Zestril)
• quinapril (Accupril)
• ramipril (Altace)

Angiotensin II Receptor Blockers

Angiotensin II receptor blockers help manage blood pressure by blocking a hormone that constricts blood vessels, allowing the vessels to relax. Doctors might prescribe ARBs to people with heart failure and high blood pressure.

• azilsartan (Edarbi)
• candesartan (Atacand)
• irbesartan (Avapro)
• losartan (Cozaar)
• olmesartan (Benicar)
• telmisartan (Micardis)
• valsartan (Diovan)

Antiplatelet Agents

Antiplatelet agents prevent the formation of blood clots by stopping platelets in the blood from clumping together. Doctors prescribe them after heart attacks, strokes, transient ischemic attacks (TIAs, or mini-strokes), and other types of cardiovascular diseases. If plaque has built up on a person’s coronary artery but isn’t yet causing a severe blockage, a person can also take antiplatelet agents to prevent a blood clot.

• aspirin
• clopidogrel (Plavix)
• dipyridamole (Persantine)
• prasugrel (Effient)
• ticagrelor (Brilinta)

Beta-Blockers

Beta-blockers work by slowing the heart rate, helping it beat less forcefully, and decreasing the effects of the hormone adrenaline on the heart. They also help lower blood pressure, so the heart doesn’t have to work as hard. Doctors prescribe beta-blockers to prevent future heart attacks in people with a history of them, as well as to treat high blood pressure, chest pain (angina), and issues with heart rhythm.

• acebutolol
• atenolol (Tenormin)
• bisoprolol
• metoprolol (Lopressor, Toprol XL)
• nadolol (Corgard)
• nebivolol (Bystolic)
• propranolol (Inderal LA, InnoPran XL)

Calcium Channel Blockers

Calcium channel blockers disrupt how calcium moves into blood vessel cells and heart cells, relaxing the blood vessels and lowering the heart rate. A healthcare professional may prescribe calcium channel blockers to treat angina, arrhythmias, or high blood pressure.

• amlodipine (Norvasc)
• diltiazem (Cardizem, Tiazac)
• felodipine (Plendil)
• nifedipine (Adalat, Procardia)
• nimodipine (Nimotop)
• nisoldipine (Sular)
• verapamil (Calan, Verelan)

Cholesterol-Lowering Medications

Cholesterol-lowering medicines, such as statins, decrease levels of low-density lipoprotein (LDL, or “bad”) cholesterol in the blood, which can help reduce the risk of severe heart problems. Statins are the most common medication doctors prescribe in this class. Other options are often only prescribed when statins cause severe side effects or don’t work as intended.

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• pitavastatin (Livalo)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)

Digitalis

Digoxin (Lanoxin) is the main digitalis medication doctors prescribe for heart disease.

Diuretics

• amiloride (Midamor)
• bumetanide (Bumex)
• chlorthalidone (Hygroton)
• furosemide (Lasix)
• hydrochlorothiazide (Esidrix, Hydrodiuril)
• triamterene (Dyrenium)
• triamterene and hydrochlorothiazide combined

GLP-1 Agonists

Vasodilators

Medications in this class include:

• isosorbide dinitrate (Isordil)
• isosorbide mononitrate (Imdur)
• hydralazine (Apresoline)
• nitroglycerin (Nitro-Bid, Nitro Stat)
• minoxidil

“If medication can’t control heart disease, then it would typically need some kind of surgery, especially if there’s a severe event,” says Majure.

The type of heart disease you have and how much heart damage has occurred will determine which procedure your doctor will recommend. Sometimes, a doctor performs these surgeries as emergency procedures.

Angioplasty

Bariatric Surgery

If you meet the criteria for bariatric surgery, a doctor may consider it as part of your heart disease treatment. Different bariatric procedures carry different risks and benefits, so speak to a healthcare professional about which surgery may be best for you.

Stent Placement

“If a person has developed coronary artery disease due to uncontrolled high blood pressure, high cholesterol levels, and other factors, they might experience a heart attack,” says Majure. “A surgeon may place a stent during an emergency procedure to try to save some of that heart muscle that’s no longer receiving blood flow.”

Bypass Surgery

Among the most effective and common procedures to treat an artery blockage, bypass surgery can increase blood flow to the heart, reduce chest pain, and lessen a person’s risk of a heart attack, as well as improve their ability to take part in physical activity.

Recovery time after a graft can vary. “Some people might leave the hospital after a bypass surgery in as little as four days, while others might need a much longer stay,” Majure says. “It really depends on the individual and their condition.”

Radiofrequency Ablation

Heart Transplant

Ventricular Assist Device

Transmyocardial Revascularization

• Eat a heart-healthy diet
• Be more active
• Avoid or quit tobacco use
• Get seven to nine hours of sleep every night

“People can do these [things] to optimize their health and avoid conditions later on,” says Majure.

Eat a Healthy Diet

• Fruits and vegetables
• Whole grains
• Fat-free or low-fat dairy products
• Fish
• Poultry
• Nuts

People following the DASH eating plan should limit:

• Red meats
• Candy
• Added sugars
• Sugar-sweetened beverages

Exercise Regularly

Majure strongly recommends being as active as possible. “Anything that gets people moving is beneficial,” he says. “Unfortunately, as a society, we don’t move enough. If someone finds an activity they enjoy, like yoga, Pilates, or even walking, they should do it.”

“Yoga, for instance, offers additional benefits like mindfulness, breathing techniques, and relaxation, which I fully support if it’s accessible,” adds Majure.

Stop Smoking

Manage Stress

Healthy stress management methods include:

• Exercise
• Relaxation techniques
• Meditation
• Talk therapy
• Leaning on friends, family, community, and religious support systems

Cardiac rehabilitation is a program of exercises and support sessions designed to help people recover after heart surgery, as well as support the health and quality of life of people with heart failure. “Cardiac rehab is really important,” says Majure. “It’s a coordinated program, usually about 36 sessions, where people go a few times a week. The goal is to rehabilitate the heart and the rest of the body, which often atrophies during illness. This holistic approach helps the person regain their full capacity.”

• Supervised exercise training, including aerobic and strength exercises
• Learning to manage cardiac risk factors through practices like stress and weight management and support for quitting smoking
• Heart health education
• Heart-healthy diet and nutrition counseling
• Emotional support and therapy

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Majure suggests rehabilitation through a formal outpatient program as the best route. “At-home recovery could work if there’s access to high-level physical therapy. However, left to their own devices, most people won’t fully rehabilitate,” he says. “We’re trying to prevent frailty and ensure people regain their optimal health and capacity. [It’s a tragedy] when people get a little better but don’t fully recover, even though the right tools, like rehab, could make a difference.”

Some people may wish to try complementary and integrative therapies alongside conventional treatment to soothe pain. “Integrative therapies like acupuncture are fine, especially if they help with pain management, as that enables people to be more active,” says Majure.

However, he recommends consulting a pharmacist before using herbal remedies, due to potential interactions with other medications. “For example, St. John’s wort can alter the levels of certain medications in the blood,” he says. “Since herbs are active compounds, they can increase or decrease medication effects, depending on the interaction. Always ensure these are safe and won’t cause harm.”

Majure also says that taking dietary supplements for heart disease might not be helpful. “Many supplements don’t help and can be a waste of money. While some might have benefits, others don’t offer much, and the cost can add up,” he says. “If there are no harmful drug interactions and someone feels strongly about taking them, I won’t discourage it. However, I caution against spending excessively on products without clear evidence of benefit.”

• aspirin
• beta-blockers
• calcium-channel blockers
• nitroglycerin
• ranolazine (Ranexa)
• statins

• Heart disease treatment often involves a variety of medications, which can help alleviate symptoms and lower the risk of serious cardiac events.
• A variety of surgeries, from minimally invasive procedures to open-heart surgery and heart transplants, can help restore heart function and improve both lifespan and quality of life.
• Lifestyle choices, such as healthy diet and exercise habits, are an integral part of heart disease treatment. Speak to a doctor about lifestyle changes you can make to improve the health of your heart.