Medical Treatment

The goal of treating atherosclerosis is to restore as much blood flow as possible to the affected areas. This goal can be achieved by reducing risk factors that can be changed through steps such as the following:

• Taking drugs to normalize blood pressure, if blood pressure is high. (See High Blood Pressure for more information.)

• Taking drugs to normalize blood sugar levels, especially for people with diabetes. (See Diabetes for more information.)

• Taking drugs to lower lipid levels, if levels are high. These drugs help lower LDL cholesterol levels and triglycerides and raise HDL cholesterol levels. Statins are the most commonly used lipid-lowering drugs because of powerful clinical trial data results over the past 11 years. (See Understanding Cholesterol-Lowering Medications.)

• Smoking cessation. The risks of cigarette smoking are reduced rapidly and significantly with smoking cessation. The relative risk is so significant that the incidence of coronary heart disease in people who have recently quit smoking is similar to that of people who have not smoked within two years. Cigarette smoking decreases the level of good cholesterol (high-density lipoprotein cholesterol or HDL cholesterol) and increases the level of bad cholesterol. Smoking is even more dangerous for people who already have a high risk of heart disease. It raises the level of carbon monoxide in the blood, which may increase the risk of injury to the lining of the arterial wall, thereby facilitating plaque formation. Smoking constricts arteries already narrowed by the plaque, further decreasing the amount of blood reaching the cells.

• Exercise, weight loss, and dietary changes are also helpful in preventing the progression of atherosclerosis.

• Aspirin should be routinely used by persons with established arteriosclerosis of any arteries and in individuals at high risk (by risk factor analysis) for arteriosclerosis. Aspirin inhibits sticky platelets floating in the blood from starting a blood clot, and final blockage of a narrowed, plaque-filled artery.