How can coronary artery disease be prevented

CHD> treatment

1. The most important things in a nutshell

The diagnosis of coronary artery disease (CHD) is often a shock for those affected. With consistent treatment, the risks of deterioration or an acute heart attack can usually be reduced. There is no cure for CHD, but with the right treatment, sufferers can achieve a good quality of life.

The most important components of therapy are a healthy lifestyle and medication. If the symptoms persist, a stent or bypass surgery may be considered.

2. Medicines

Medicines can help alleviate symptoms and prevent secondary diseases. So they affect the quality of life and can extend life.

The following drugs are used for CHD and can reduce the risk of a heart attack or sudden cardiac death:

  • Platelet inhibitors (platelet aggregation inhibitors) prevent blood platelets (thrombocytes) from clumping together, adhering to the vessel walls and constricting or clogging the coronary arteries. The best-known active ingredient is acetysalicylic acid (ASA).
  • Statins (cholesterol-lowering drugs) can lower blood cholesterol and also have a beneficial effect on other blood fats (lipids). This can prevent the formation of plaques.
  • Beta blockers and ACE inhibitors belong to the antihypertensive drugs. In addition to lowering blood pressure, beta blockers also reduce the heart's need for oxygen and slow the heartbeat. ACE inhibitors also lower blood pressure and improve the pumping capacity of the heart. Both means ensure that the heart is relieved.
  • Nitrates expand the blood vessels and improve the blood supply to the heart. Fast-acting nitrates are used, for example, as "nitro spray" or "nitro capsule" in an acute angina pectoris attack to relieve tightness and pain in the chest. CHD patients should always have a fast-acting nitrate with them in case of an emergency. Nitrates should only be used for symptom relief.

Different drugs are often combined with one another.

3. Invasive treatments

Invasive ("penetrating") treatments include stents and bypass surgery. Whether a stent or a bypass operation is necessary and which method is more suitable depends on the extent of the disease, possible concomitant diseases and individual wishes.

Both stents and bypass operations can quickly relieve symptoms and improve quality of life, but they can also be associated with side effects such as vascular injuries, blood loss and the risk of anesthesia.

3.1. Stent

A stent is a thin tube made of wire mesh that can hold open narrowed areas in the blood vessel and thereby improve blood flow. As with a cardiac catheter examination, a thin probe (catheter) is advanced over the artery of the groin or arm through the main artery (aorta) to the narrowed areas of the coronary artery. A small balloon and stent are attached to the tip of the catheter. With the help of the balloon, the constriction is first widened (balloon dilation) and then the stent is inserted so that the blood can flow better through the vessel again.
Stents are mainly used in emergencies such as a heart attack. In the case of stable angina pectoris, however, they can also alleviate symptoms if medication does not provide sufficient relief.

3.2. Bypass surgery

Bypass is the English word for bypass. In an open heart surgery, narrowed blood vessels are bridged by the body's own tissue. During the operation, the patient is connected to a heart-lung machine. Even after a bypass operation, medication must be taken permanently.

Studies have shown that bypass surgery is less likely to require re-intervention than after a stent. In addition, the mortality rate can be reduced slightly better by an operation compared to a stent. However, an operation also carries risks such as strokes, which is why a patient should inform himself as fully as possible before an operation.

3.2.1. Practical tip

The patient information sheet "Constricted coronary arteries: stent or bypass?" Can be an aid to decision-making. It can be downloaded free of charge at www.patienten-information.de> search term: "stent or bypass".

4. Movement

Lack of exercise is an independent risk factor for CHD, so exercise is accordingly important in the treatment concept. The less well the heart is trained, the higher the probability of getting sick. Conversely, sport and exercise protect against the disease, even if you have already suffered a heart attack, for example. However, a lot of sport is enough Not to compensate for other risk factors.

Regular exercise improves the body's resilience and performance by lowering blood pressure and heart rate. Sport leads to mental stabilization because it increases self-esteem and reduces fears. It makes it easier to lose and maintain weight, helps to reduce smoking and has a positive effect on cholesterol levels.

Sport cannot be valued highly enough for people with heart disease. Heart specialists now assume that it is just as important as medication.

It is important that the training is individually adapted to the patient's resilience. The prerequisite for this is that the so-called "submaximal" resilience is determined in cardiac patients. "Submaximal" means that the patient exercises, but does not stress his heart too much. Heart patients should not become out of breath while exercising. With the help of an ergometer, the optimal duration and intensity (pulse frequency) are determined.

Stable heart patients are usually advised to exercise for 30 minutes at least 4 days a week.

4.1. Cheap sports

Endurance sports are particularly suitable for cardiac training

  • To go biking
  • To run
  • Walking
  • Cross-country skiing
  • Slow mountain hikes up to an altitude of 2,500 m
  • Swimming (not too cold water)

Sports with peaks of exertion and stress potential are less suitable. Strength training is controversial: Moving borderline loads is certainly unsuitable. Exercising on the "low weight, slow motion, high rep" formula can be beneficial. Strength training should only be done under medical supervision.

4.2. Cardiac sports groups

Many sports clubs, sports studios and disabled sports associations offer special cardiac sports groups. Participation in a cardiac exercise group is particularly recommended for patients who cannot or do not want to do sports alone because of their CHD. Some are directly linked to medical care. The health insurance companies or doctors provide addresses.

Participation in a cardiac sports group is financed under certain conditions by health insurance or pension insurance as a rehabilitation sport. Rehabilitation sports groups are fixed groups with specially trained trainers and under medical supervision.

The Pension insurance As a rule, rehabilitation sports take over for 6 months, or 1 year if medically necessary.

The Health insurance takes on 90 exercise units (children with heart disease 120) within 2 years. A prerequisite is a chronic heart disease including coronary heart disease, heart failure, cardiomyopathies, valve diseases and after cardiovascular interventions / operations). Further prescriptions are possible if, due to a heart disease or cardiac ischemia criteria, a maximum load limit of less than 1.4 watts / kg body weight is measured. A further regulation may include 45 exercise units each within 1 year.

A new prescription for 2 years at the expense of the health insurance is possible after the following events with acute treatment:

  • Acute cardiovascular arrest
  • Acute coronary syndrome, myocardial infarction, or unstable angina pectoris
  • Hospital treatment for heart failure or cardiomyopathy (except hypertrophic cardiomyopathy or myocarditis less than 6 months old)
  • Intervention / surgery on the coronary arteries (PCI, bypass surgery)
  • Intervention / surgery on the heart valves
  • Implantation of an ICD (implantable cardioverter defibrillator), a PM (cardiac pacemaker) or CRT-P (biventricular cardiac pacemaker)
  • Heart transplant

4.3. Practical tips

  • Under no circumstances should you train with illnesses such as febrile infections.
  • Regular physical exercise does not only consist of endurance training, but can be implemented constantly in everyday life, e.g. leaving the car behind, walking or cycling. Instead of taking the elevator, climb stairs. Do not use a remote control or cordless phone. To often go for a walk.

5. Diet

A healthy diet, along with the other treatment components, helps to slow down or stop the progression of coronary heart disease (CHD). Certain nutritional factors are now considered to be safe for the prevention of CHD:

  • Abundant consumption of fruit, vegetables and whole grain products (5 to 6 times a day)
  • Replace saturated fat and trans fat with unsaturated fat. That means: Avoiding animal fats and instead using vegetable fats such as olive, sunflower or safflower oil. fatpoor Use milk and dairy products.
  • Consume more omega-3 fatty acids. They can be found in linseed oil, walnuts and chia seeds, for example.
  • Steamed, grilled or steamed dishes are lower in fat than fried, deep-fried or gratinated dishes and should therefore be preferred.
  • Minor Lots of red wine will reduce the harmful effects of LDL cholesterol and increase HDL cholesterol. However, this recommendation is now controversial, as alcohol always acts as a cell poison.
  • If you are overweight: avoid desserts.
  • If you have high blood pressure: Avoid salty foods, e.g. sausage, ready meals, certain types of bread.

Basically, obesity should be reduced. This not only requires proper nutrition, but also regular exercise, see above.

6. Stress relief

It has been proven that negative stress significantly increases the risk of CHD. The adrenaline level rises in stressful situations. If this condition lasts longer, it can lead to the formation of numerous inflammatory substances and the body's defenses work less well. This increases the risk of a heart attack.
The same applies to certain traits such as ambition, competition, extreme feelings of lack of time and aggressiveness. That is why it is crucial not to simply accept stress, but to recognize it in order to be able to consciously counteract it.

  • Check daily and work routine
    Can time bottlenecks and the resulting stressful situations be avoided through better planning?
  • Tendency to feel responsible for everything
    Get rid of the idea of ​​wanting to do everything perfectly and yourself. Learning to distinguish what is important from what is unimportant. Don't let everything charge you up. Be more relaxed.
  • Relaxation techniques
    such as autogenic training, yoga, progressive muscle relaxation (PMS) or the Feldenkrais method.
  • to do sports

Courses to learn a relaxation technique are part of the service catalog of many health insurance companies. Adult education centers and seminar providers also have corresponding courses in their program, which are subsidized by most health insurance companies.

6.1. Stresses as a result of the disease

If a person has coronary artery disease or has already been diagnosed with angina pectoris or a heart attack, fear and depression are a natural reaction: after all, they have just experienced a life-threatening situation. After a previously independent life, the diagnosis unsettled and many patients are reluctant to admit their health weaknesses.

  • If you have self-doubt or depression, accept help, even if it is difficult.
    More information under Depression> Treatment.
  • Maintain good social relationships and ensure a good work-life balance. Social and life satisfaction affect the hormones and parts of the nervous system.

Self-help groups and advice centers help you deal with your risk of illness in the best possible way. Contacts under KHK> Addresses.

7. Quit smoking

Smoking damages the blood vessels. CHD patients can significantly reduce their mortality and heart attack risk by quitting smoking. There are several things you can do to help you quit smoking. More information under smoking cessation.

8. Related links

Coronary artery disease guide

Rehabilitation sports and functional training

Disability> sport

Disability> Vacation and free time

Coronary heart disease

KHK> General

KHK> driving a car

KHK> family and living

CHD> sexuality

KHK> vacation