Heart Disease Treatment: Medication, Lifestyle Changes, and More
Heart disease treatment aims to reduce the risk of severe cardiac events, such as a heart attack or stroke, as well as relieve symptoms like chest pain and reduced exercise capacity. Treating heart disease can involve a range of approaches, from lifestyle changes to long-term medications and surgery.
The term “heart disease” covers a variety of different conditions, such as coronary artery disease, heart failure, and arrhythmia, which can all differ in severity and require different solutions.
Your doctor will devise the treatment plan that’s best for your needs. Reducing your risk of complications may also involve keeping other conditions like diabetes or high cholesterol in check. Follow directions carefully and talk to your doctor before starting or combining treatments.
A doctor may prescribe medication to treat heart disease long before you experience symptoms, says David Taylor Majure, MD, MPH, medical director of the heart transplant service at NewYork Presbyterian/Weill Cornell Medical Center.
“You’re trying to prevent something like heart failure or stroke in the future,” says Dr. Majure. “But 10 years before that event happens, [you] might feel okay.”
A doctor’s role in prescribing heart disease medication involves helping people understand the end goal, says Majure. Some people may experience side effects with these medications, so understanding how they work is key. “It’s not just bringing that blood pressure number down. It’s trying to prevent something in the future,” says Majure.
There are many types of medication that are prescribed to treat and prevent heart disease:
Anticoagulants
Anticoagulants are blood-thinning medications that help prevent harmful blood clots from forming or growing. Doctors often prescribe these medications to prevent a person’s first stroke, repeated strokes after a first stroke, or a heart attack.
Medications in this class include:
apixaban (Eliquis)
dabigatran (Pradaxa)
edoxaban (Savaysa)
heparin (various)
rivaroxaban (Xarelto)
warfarin (Coumadin)
Angiotensin-Converting Enzyme Inhibitors
ACE inhibitors expand blood vessels by lowering levels of hormones that regulate blood pressure, reducing how hard the heart has to work to pump blood. This allows blood to flow through the body more efficiently, helping to treat high blood pressure and supporting health after a heart attack.
Medications in this class include:
benazepril (Lotensin)
enalapril (Vasotec)
fosinopril (Monopril)
lisinopril (Prinivil, Zestril)
quinapril (Accupril)
ramipril (Altace)
Angiotensin II Receptor Blockers
Angiotensin II receptor blockers help manage blood pressure by blocking a hormone that constricts blood vessels, allowing the vessels to relax. Doctors might prescribe ARBs to people with heart failure and high blood pressure.
Medications in this class include:
azilsartan (Edarbi)
candesartan (Atacand)
irbesartan (Avapro)
losartan (Cozaar)
olmesartan (Benicar)
telmisartan (Micardis)
valsartan (Diovan)
Sometimes doctors prescribe sacubitril/valsartan (Entresto), a combination of ARBs and neprilysin inhibitors known as an angiotensin receptor-neprilysin inhibitor. This heart failure treatment improves how the arteries open, reduces how much sodium the body retains, and limits stress on the heart.
Antiplatelet Agents
Antiplatelet agents prevent the formation of blood clots by stopping platelets in the blood from clumping together. Doctors prescribe them after heart attacks, strokes, transient ischemic attacks (TIAs, or mini-strokes), and other types of cardiovascular diseases. If plaque has built up on a person’s coronary artery but isn’t yet causing a severe blockage, a person can also take antiplatelet agents to prevent a blood clot.
Nearly every person with coronary artery disease will need to take aspirin for the rest of their life.
People who have undergone surgery like stent placement or coronary bypass graft surgery, or those who have had a heart attack, may benefit from taking another antiplatelet medication known as a P2Y12 inhibitor at the same time. This combination is known as dual antiplatelet therapy.
Beta-Blockers
Beta-blockers work by slowing the heart rate, helping it beat less forcefully, and decreasing the effects of the hormone adrenaline on the heart. They also help lower blood pressure, so the heart doesn’t have to work as hard. Doctors prescribe beta-blockers to prevent future heart attacks in people with a history of them, as well as to treat high blood pressure, chest pain (angina), and issues with heart rhythm.
Medications in this class include:
acebutolol
atenolol (Tenormin)
bisoprolol
metoprolol (Lopressor, Toprol XL)
nadolol (Corgard)
nebivolol (Bystolic)
propranolol (Inderal LA, InnoPran XL)
Calcium Channel Blockers
Calcium channel blockers disrupt how calcium moves into blood vessel cells and heart cells, relaxing the blood vessels and lowering the heart rate. A healthcare professional may prescribe calcium channel blockers to treat angina, arrhythmias, or high blood pressure.
Medications in this class include:
amlodipine (Norvasc)
diltiazem (Cardizem, Tiazac)
felodipine (Plendil)
nifedipine (Adalat, Procardia)
nimodipine (Nimotop)
nisoldipine (Sular)
verapamil (Calan, Verelan)
Cholesterol-Lowering Medications
Cholesterol-lowering medicines, such as statins, decrease levels of low-density lipoprotein (LDL, or “bad”) cholesterol in the blood, which can help reduce the risk of severe heart problems. Statins are the most common medication doctors prescribe in this class. Other options are often only prescribed when statins cause severe side effects or don’t work as intended.
Statins include:
atorvastatin (Lipitor)
fluvastatin (Lescol)
lovastatin (Mevacor)
pitavastatin (Livalo)
pravastatin (Pravachol)
rosuvastatin (Crestor)
simvastatin (Zocor)
Other medication classes that reduce cholesterol include nicotinic acids like niacin or cholesterol absorption inhibitors, such as ezetimibe (Zetia). Some medications like ezetimibe/simvastatin (Vytorin) combine statins with cholesterol absorption inhibitors.
Digitalis
Digitalis can help the heart contract harder when its pumping function has been weakened and can slow a rapid heartbeat. This medication can help people manage arrhythmias like atrial fibrillation or heart failure symptoms when they don’t get good results from ACE inhibitors, ARBs, or diuretics.
Digoxin (Lanoxin) is the main digitalis medication doctors prescribe for heart disease.
Diuretics
Diuretics, or “water pills,” eliminate excess fluids and sodium through urination, helping relieve the heart’s workload and reduce blood pressure. These pills also decrease fluid backup in the lungs and other parts of the body, such as the ankles and legs, due to heart failure.
“Thiazide diuretics are among the oldest heart disease medications,” says Majure. “They’ve been around since the 1960s, and we use them to this day.” Other diuretics include loop diuretics and potassium-sparing diuretics.
Medications in these classes include:
amiloride (Midamor)
bumetanide (Bumex)
chlorthalidone (Hygroton)
furosemide (Lasix)
hydrochlorothiazide (Esidrix, Hydrodiuril)
triamterene (Dyrenium)
triamterene and hydrochlorothiazide combined
GLP-1 Agonists
GLP-1 agonists like semaglutide mimic a hormone that the small intestine produces that leads to insulin release, blocks glucose-releasing hormones, helps the stomach empty more slowly, and increases a person’s feelings of fullness after eating. These drugs were developed to treat type 2 diabetes and are also prescribed to treat obesity. They can have a broad range of positive effects on heart disease risk factors.
In 2024, the U.S. Food and Drug Administration approved Wegovy, a drug containing semaglutide, to reduce the risk of stroke, heart attack, and heart disease–related death in people who are overweight or have obesity.
Vasodilators
Vasodilators expand blood vessels to improve blood flow to the heart, decreasing the effort of pumping and controlling blood pressure. Nitrates, one type of vasodilator, improve blood and oxygen supply to the heart, which can help reduce angina. Pregnant women can also take this medication to reduce high blood pressure.
Medications in this class include:
isosorbide dinitrate (Isordil)
isosorbide mononitrate (Imdur)
hydralazine (Apresoline)
nitroglycerin (Nitro-Bid, Nitro Stat)
minoxidil
“If medication can’t control heart disease, then it would typically need some kind of surgery, especially if there’s a severe event,” says Majure.
The type of heart disease you have and how much heart damage has occurred will determine which procedure your doctor will recommend. Sometimes, a doctor performs these surgeries as emergency procedures.
Angioplasty
During an angioplasty, a surgeon threads tubing with an attached deflated balloon to the coronary artery. Inflating the balloon widens areas where a blockage has slowed or stopped blood flow to the heart.
This minimally invasive procedure can reduce angina and improve a person’s capacity for physical activity. The same procedure can be used to widen arteries in the brain and neck to prevent stroke. The surgeon can also remove plaque using a laser or rotating shaver.
Bariatric Surgery
Bariatric surgery, or weight loss surgery, may be an option for people with heart disease and obesity. This type of surgery reduces how much food the stomach can hold and the amount of fat and calories the body can absorb. While bariatric surgery isn’t a heart procedure, the resulting weight loss can improve heart function and reduce a person’s risk of severe heart complications. Bariatric surgery can also treat related conditions like diabetes, high blood pressure, and high cholesterol.
If you meet the criteria for bariatric surgery, a doctor may consider it as part of your heart disease treatment. Different bariatric procedures carry different risks and benefits, so speak to a healthcare professional about which surgery may be best for you.
Stent Placement
This procedure involves using a wire mesh tube called a stent to prop open an artery during an angioplasty. This stent stays in place permanently.
“If a person has developed coronary artery disease due to uncontrolled high blood pressure, high cholesterol levels, and other factors, they might experience a heart attack,” says Majure. “A surgeon may place a stent during an emergency procedure to try to save some of that heart muscle that’s no longer receiving blood flow.”
Bypass Surgery
Among the most effective and common procedures to treat an artery blockage, bypass surgery can increase blood flow to the heart, reduce chest pain, and lessen a person’s risk of a heart attack, as well as improve their ability to take part in physical activity.
A coronary artery bypass treats blocked arteries by grafting arteries or veins from other parts of the body and using them to reroute blood around clogged arteries to improve blood flow to the heart. People may need multiple grafts, depending on how many arteries have a blockage. This procedure often involves an in-hospital stay of several days.
Recovery time after a graft can vary. “Some people might leave the hospital after a bypass surgery in as little as four days, while others might need a much longer stay,” Majure says. “It really depends on the individual and their condition.”
Radiofrequency Ablation
Radiofrequency ablation can treat some heart rhythm problems if drugs have not had the desired effect. The procedure involves a surgeon guiding a catheter with an electrode at its tip through the veins to the heart muscle. Using mild and painless radiofrequency energy, the surgeon can destroy the cells that cause an abnormal heart rhythm.
Heart Transplant
A heart transplant is a rare and complex surgery that doctors consider only when medications and other procedures are deemed ineffective in supporting heart health. A heart transplant may become necessary after a heart has undergone irreversible damage due to severe arrhythmias, coronary heart disease, or heart failure. The procedure involves removing a damaged heart and replacing it with a healthy one from an organ donor. After a transplant, a donated heart lasts a median of 12.5 years. People must take medications to suppress the immune system after the procedure to prevent the body from rejecting the new organ as foreign tissue.
Ventricular Assist Device
A ventricular assist device (VAD) is a mechanical device, inserted during open heart surgery, that helps the lower chambers of the heart pump blood. A VAD may be an option for people with heart failure or a weak heart. Heart surgeons most often place VADs in the left ventricle, the heart’s lower left chamber. During the procedure, surgeons usually stop the heart and connect people to a heart-lung bypass machine that supplies the body with oxygen-rich blood.
The device connects to a battery pack and control unit outside the body. People may undergo a VAD implant as a temporary solution while waiting for a heart transplant or recovering from heart failure. Otherwise, it’s considered permanent, referred to as destination therapy. A VAD can improve quality of life in a person with heart failure.
Transmyocardial Revascularization
During a transmyocardial revascularization (TMR) procedure, a surgeon creates tiny holes in the left ventricle to allow more oxygen-rich blood to reach the heart and reduce angina in people with coronary artery disease. A TMR can be a safe and effective alternative if procedures like bypass surgery or angioplasty with stenting carry too high a risk in people with advanced heart disease or other health problems.
Lifestyle modifications are often the first steps when managing heart disease, and self-care for heart disease remains important alongside medical treatment. Majure recommends following healthy behaviors recommended by the American Heart Association (AHA):
“People can do these [things] to optimize their health and avoid conditions later on,” says Majure.
Eat a Healthy Diet
The AHA specifically recommends the Dietary Approaches to Stop Hypertension (DASH) eating plan for optimal heart health. The DASH diet focuses on heart-healthy foods that are low in fat, cholesterol, and sodium, and rich in nutrients, protein, and fiber. Foods to focus on include:
Fruits and vegetables
Whole grains
Fat-free or low-fat dairy products
Fish
Poultry
Nuts
People following the DASH eating plan should limit:
Red meats
Candy
Added sugars
Sugar-sweetened beverages
Exercise Regularly
Physical activity can help strengthen your heart and improve circulation. For optimal heart health, the AHA recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity spread throughout the week. People should also include moderate- to high-intensity muscle-strengthening activity two days a week.
Majure strongly recommends being as active as possible. “Anything that gets people moving is beneficial,” he says. “Unfortunately, as a society, we don’t move enough. If someone finds an activity they enjoy, like yoga, Pilates, or even walking, they should do it.”
“Yoga, for instance, offers additional benefits like mindfulness, breathing techniques, and relaxation, which I fully support if it’s accessible,” adds Majure.
People with heart disease should consult a doctor for recommendations on the safest approach, as some may advise to restrict certain types of exercise to prevent excess strain on the heart. Physicians often suggest lighter aerobic activity and resistance training, prioritizing stable breathing, ample warm-up and cool-down time, and taking rest breaks before you feel too tired.
Stop Smoking
If you use tobacco, it’s important to support your heart treatment by quitting. The nicotine in tobacco raises blood pressure, making the heart work harder, and leads to a higher risk of heart attack and stroke. Talk to your doctor about methods for quitting that will work best for you. And if you don’t already smoke, steering clear of it is best for your heart health.
Manage Stress
Chronic stress can affect the heart in many ways, including raising blood pressure, blood sugar, and inflammation, all of which can contribute to heart disease. Stress can even trigger chest pain and heart attacks in some people. Additionally, some people cope with stress in unhealthy ways, such as overeating or turning to alcohol consumption or tobacco use, all of which increase the risk of heart disease.
Healthy stress management methods include:
Exercise
Relaxation techniques
Meditation
Talk therapy
Leaning on friends, family, community, and religious support systems
Cardiac rehabilitation is a program of exercises and support sessions designed to help people recover after heart surgery, as well as support the health and quality of life of people with heart failure. “Cardiac rehab is really important,” says Majure. “It’s a coordinated program, usually about 36 sessions, where people go a few times a week. The goal is to rehabilitate the heart and the rest of the body, which often atrophies during illness. This holistic approach helps the person regain their full capacity.”
A cardiac rehabilitation program starts while you’re still recovering at the hospital and continues in outpatient visits after you leave. Once you complete the sessions, you may need to continue the exercises on your own. A program includes five main components:
Supervised exercise training, including aerobic and strength exercises
Learning to manage cardiac risk factors through practices like stress and weight management and support for quitting smoking
Heart health education
Heart-healthy diet and nutrition counseling
Emotional support and therapy
At-home cardiac rehabilitation is also available, but health insurance doesn’t always cover it, so check with your provider.
Majure suggests rehabilitation through a formal outpatient program as the best route. “At-home recovery could work if there’s access to high-level physical therapy. However, left to their own devices, most people won’t fully rehabilitate,” he says. “We’re trying to prevent frailty and ensure people regain their optimal health and capacity. [It’s a tragedy] when people get a little better but don’t fully recover, even though the right tools, like rehab, could make a difference.”
Some people may wish to try complementary and integrative therapies alongside conventional treatment to soothe pain. “Integrative therapies like acupuncture are fine, especially if they help with pain management, as that enables people to be more active,” says Majure.
However, he recommends consulting a pharmacist before using herbal remedies, due to potential interactions with other medications. “For example, St. John’s wort can alter the levels of certain medications in the blood,” he says. “Since herbs are active compounds, they can increase or decrease medication effects, depending on the interaction. Always ensure these are safe and won’t cause harm.”
Majure also says that taking dietary supplements for heart disease might not be helpful. “Many supplements don’t help and can be a waste of money. While some might have benefits, others don’t offer much, and the cost can add up,” he says. “If there are no harmful drug interactions and someone feels strongly about taking them, I won’t discourage it. However, I caution against spending excessively on products without clear evidence of benefit.”
Angina, or chest pain, is a common symptom of heart disease. This discomfort occurs as a result of reduced blood flow to the heart, and most describe it as a squeezing, pressure, heaviness, tightness, or painful sensation in the chest. A doctor may prescribe any of the following medications to help manage angina:
aspirin
beta-blockers
calcium-channel blockers
nitroglycerin
ranolazine (Ranexa)
statins
People with heart disease may need to be careful using standard pain medications. For instance, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may increase the risk of blood clots. NSAIDs also cause blood flow in the kidneys to change, causing the body to retain more salt and water. This retention increases blood pressure and can make a stroke or atrial fibrillation more likely.
The AHA recommends using heated pads, physical therapy, or ice to manage pain before trying pain relief medications. If further relief is necessary, taking the lowest possible dose of naproxen (Aleve) might be safer than other medications.
Heart disease treatment often involves a variety of medications, which can help alleviate symptoms and lower the risk of serious cardiac events.
A variety of surgeries, from minimally invasive procedures to open-heart surgery and heart transplants, can help restore heart function and improve both lifespan and quality of life.
Lifestyle choices, such as healthy diet and exercise habits, are an integral part of heart disease treatment. Speak to a doctor about lifestyle changes you can make to improve the health of your heart.