Forms of therapy
Causal therapy approaches serve primary (measures to prevent CHD) and secondary prevention (measures to prevent the progression and worsening of CHD). Fundamental to both forms of prevention is the elimination of risk factors that can be influenced and that promote the development of coronary heart disease (CHD), i.e:
- Body weight reduction
- Nicotine abstinence (stop smoking)
- Optimal adjustment of diabetes mellitus-increased blood lipids (especially hypercholesterolemia), high blood pressure (hypertension)
- Physical training (especially endurance training) and
- Change of diet.
Angina pectoris
The symptomatic therapy of acute stable angina pectoris attacks consists of the administration of a short-acting nitro preparation such as glycerol trinitrate as a spray or bite capsule. This drug improves blood circulation in the inner layer of the heart and reduces the oxygen requirement of the heart muscle (myocardium).
Drugs
Long-term drug therapy, which serves as secondary prevention, is intended to improve the supply of blood to the heart muscle and prevent the coronary arteries (coronaries) from being blocked by blood clots (thrombi). It consists of the following groups of drugs:
- Nitrates are not only used for acute or emergency therapy, but also for long-term therapy. In this context, long-acting nitrates are used, such as isosorbide mononitrate or isosorbide dinitrate and molsidomine, which dilate the coronary vessels and thus improve the oxygen supply to the heart.
- The heart rate, the number of heartbeats per minute, as well as blood pressure are lowered with the help of beta-receptor blockers, which leads to a reduced oxygen demand of the heart under stress.
Mortality (lethality) is reduced in acute heart attack patients and patients who have had a heart attack by using beta blockers. This group of drugs should be used with caution in asthma patients and diabetics, as bronchial constriction can occur and the signs of hypoglycaemia may be masked by the drug’s effect.
- If the administration of beta-receptor blockers is not possible due to contraindications that the patient has, calcium antagonists can be administered as reserve medication, whereby care must be taken to use long-acting calcium antagonists, as the clinical picture of the patient would be negatively affected by short-acting medication.
- Clopidogrel or aspirin are used to inhibit coagulation, so that vasoconstrictive thromboses (venous vessel occlusion) or embolisms (arterial vessel occlusion) are avoided. It is necessary to monitor this effect as well as potential side effects of the drugs by regular controls.
- Cholesterol synthesis inhibitors (e.g. simvastatin) are used to lower blood cholesterol levels, which is a risk factor for the development of CHD.
- Of course, the circulatory disorder can also be treated with homeopathic medication.
