Treatment Options

Eating a healthy diet, exercising regularly, not smoking, and other healthy lifestyle choices can improve your heart's health. Some women also may need to take the following medications to prevent or treat cardiovascular disease.

· Aspirin helps prevent heart attacks when taken regularly in a low dose with your physician's approval.

· Beta-blockers lower blood pressure by reducing the force with which the heart pumps. These drugs block the action of substances that increase heart rate and blood pressure. Beta-blockers also are used to treat chest pain and to prevent a second heart attack.

· ACE inhibitors are used to lower blood pressure after a heart attack when the heart muscle has been damaged. They're also often used for patients who have diabetes. ACE inhibitors work by halting the production of a chemical that causes blood vessels to narrow.

· Digitalis makes the heart contract harder. It's used when the heart's pumping function has been weakened, as well as to slow quick heart rhythms.

· Diuretics cause the kidneys to excrete more water and salts than normal, thereby reducing blood volume and lowering blood pressure.

· Calcium channel blockers are used to lower blood pressure and to treat chest pain. Beta-blockers and diuretics are often used first for high blood pressure, while calcium channel blockers may be used if these are not effective, are not well tolerated, or are contraindicated. It's important not to drink grapefruit juice for at least 4 hours after taking a calcium channel blocker. According to the American Heart Association, recent studies show that there is a compound in grapefruit juice that appears to interfere with the liver's ability to clear certain drugs from the body.

· Nitrates (including nitroglycerine) relax blood vessels and reduce chest pain.

· Common blood cholesterol-lowering agents are often prescribed, including statins (HMG CoA reductase inhibitors), bile acid sequestrants, fibric acid derivatives, and nicotinic acid (niacin).

Women and statins
The benefits of using statins to lower cholesterol levels in women are dramatic. In a 1996 study involving 4,200 heart-attack survivors, Boston researchers found that giving a statin lowered the risk for another heart attack by 20 percent in men and 46 percent in women.

Medication alert
Because all drugs prescribed to prevent or treat heart disease have side effects, it's important to know as much as possible before taking them. Make a list of the medications you're taking, including over-the-counter medications and supplements, before visiting your physician. This list can help your doctor prescribe medications that you can take safely without dangerous drug interactions.

In addition, never stop taking any heart medication without first consulting your physician.

When surgery is necessary
Women with advanced heart disease may need to undergo surgery to open an artery and improve circulation. These procedures can reduce severe chest pain and clear blockages in the blood vessels:

· Coronary angioplasty (also known as "balloon" angioplasty). A surgeon inserts a thin tube through an artery to the narrowed heart vessel and inflates a small balloon at its tip. The balloon flattens the buildup and lengthens the artery to increase blood flow. The balloon is then deflated and removed, along with the tube. Sometimes "stents" may be placed in the artery after the balloon is removed to help keep the vessel open.

· A "Primary Angioplasty" is available 24 hours a day/7 days a week, as the initial treatment to stop a heart attack and limit how much damage there is to your heart. To learn more about this procedure "Step by Step" -- click here.

· Coronary artery bypass graft surgery (also known as "bypass surgery"). Surgeons take a section of a blood vessel from the leg or chest and stitch it onto the narrowed heart artery, creating a bypass around the blockage. In some cases, more than one bypass is necessary. Bypass surgery is often chosen when the blockages are hard to reach or are too long or hard for angioplasty. A person who undergoes bypass surgery usually stays in the hospital about 1 week and requires several weeks of recuperation at home. To learn more about this procedure "Step by Step" -- click here.

References:
1. "Treatment of High Blood Pressure," National Heart, Lung and Blood Institute (NHLBI), 2002.
2. "Heart Disease and Medications," NHLBI, 2002.
3. "Statin Drugs Lower Heart Disease Risk in Postmenopausal Women," American Heart Association, June 4, 2002.
4. "Heart Disease and Medications," NHLBI, 2002.
5. "Special Procedures," NHLBI, 2002.