Evaluating Treatments for Coronary Heart Disease

Cardiovascular disease is a general term that describes conditions affecting the heart or blood vessels. Both the heart and blood vessels make up the cardiovascular system.

The coronary arteries supply blood to the heart. Coronary heart disease (CHD) causes layers of fatty material to build up inside the coronary arteries. This makes the lumen of the arteries narrower and less elastic. As a result, less blood can flow through, and therefore, less oxygen reaches the heart.

  • The fatty material is mainly composed of cholesterol

With less oxygen reaching the heart, it can become strained, as it requires oxygen to keep pumping. This can potentially lead to a heart attack.

Treating coronary heart disease requires either increasing the width of the lumen or lowering blood cholesterol. The two main methods of treatment are:

  • Stents
  • Statins

Stents

Stents are expandable tubes placed inside the arteries, holding them open so that blood can keep flowing.

1. A narrow tube with a balloon is inserted into the blocked artery.

2. The balloon is inflated to expand the stent against the wall of the artery (this increases the width of the lumen).

3. The tube and balloon are removed, leaving the stent expanded.

Advantages

  • A relatively quick and simple surgery
  • Effective at reducing the risk of a heart attack
  • Lasts a long time

Disadvantages

  • The procedure requires surgery, which carries risks such as heart attacks or infections
  • There is a risk of the patient developing a blood clot
  • It can result in serious bleeding

Statins

Cholesterol is an essential lipid but there are two types:

  • LDL – Bad cholesterol
  • HDL – Good cholesterol

Statins are drugs that help reduce the level of LDL cholesterol in the bloodstream. The statins block an enzyme in the liver that is required to produce cholesterol. This reduces the rate at which fatty deposits build up, decreasing the risk of coronary heart disease (CHD).

Advantages

  • Reduces the level of LDL (bad) cholesterol
  • Increases the level of HDL (good) cholesterol, which can help to get rid of fatty deposits
  • They not only decrease the chances of CHD but also reduce the risk of strokes and heart attacks

Disadvantages

  • Must be taken regularly over long periods of time
  • Can cause side effects, such as muscle pains, headaches and even kidney failure
  • Should not be prescribed to pregnant or breastfeeding women

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