There is no cure for atherosclerosis, but treatment can slow or halt the worsening of the disease. The major treatment goal is to prevent significant narrowing of the arteries so that symptoms never develop and vital organs are never damaged. To do this, you would begin by following the healthy lifestyle outlined above. If you have high cholesterol that cannot be controlled by diet and exercise, medication may be necessary. There are currently five classes of cholesterol-lowering medications:
HMG-CoA reductase inhibitors, including lovastatin (Mevacor), simvastatin (Zocor), pravastatin (Pravachol), fluvastatin (Lescol), rosuvastatin (Crestor), and atorvastatin (Lipitor). HMG-CoA reductase inhibitors block an enzyme called HMG-CoA reductase, which controls the production of cholesterol in the liver.
Bile acid-binding resins, including cholestyramine (Questran) and colestipol (Colestid)
Fibrates, including gemfibrozil (Lopid) and fenofibrate (Tricor)
Cholesterol-absorption inhibitors, which is the newest class of cholesterol lowering agents. Ezetimibe (Zetia) is currently the only one on the market.
Once symptoms of atherosclerosis-related organ damage develop, the specific treatment depends on the organ involved:
Heart — Treatments for coronary artery disease include medications to manage symptoms of angina (nitrates, beta-blockers, calcium channel blockers) and prevent heart attacks (aspirin and beta-blockers); balloon angioplasty often with wire mesh stents; and, less commonly, coronary artery bypass surgery.
Brain — Treatments to help prevent transient ischemic attacks (TIAs) and stroke include antiplatelet medications such as aspirin, dipyridamole and clopidogrel (Plavix), and anticoagulant medications such as warfarin and heparin.
Abdomen — When atherosclerosis narrows arteries that supply the bowel, the patient may be treated with balloon angioplasty with or without stents or a bypass arterial graft.
Legs — The mainstays of treatment for intermittent claudication are quitting smoking, exercise (usually a walking program), and aspirin. People with severe arterial narrowing may be treated with balloon angioplasty with or without stents, laser angioplasty, atherectomy or bypass grafts.