Other Names : CAD, Coronary Heart Disease (CHD), Heart Disease, Ischemic Heart Disease.

Coronary heart disease is one of the most serious medical conditions in the United States and stable angina pectoris is one of its more common presentations. Three major controversies are risk factor management, drug therapy, and intervention. As well as the major risk factors stated by the Framingham study and European guidelines, other factors include abdominal obesity, metabolic syndrome, and psychological stress.

Drug therapy for Coronary Artery Disease
Apart from aspirin, many patients with stable angina are considered by the medical establishment to start statin treatment. Although statins may reduce coronary events by about one third in patients with vascular disease, the absolute benefit depends on the absolute risk. Many patients may benefit from natural lifestyle changes or natural supplements.
     Some patients may benefit from angiotensin-converting-enzyme inhibitors. The concept that beta blockers are protective from future coronary events is disputed.

Natural Supplements for Those with Coronary Artery Disease
It's a good idea to take a daily multivitamin and mineral capsule that provides the RDA for the B vitamins with additional antioxidants such as Vitamins C and E. Very high doses of multivitamins are not recommended.

Surgical Options for Coronary Artery Disease
Percutaneous coronary intervention can relieve symptoms without extending lifespan beyond medical therapy. However, strong mortality data favor coronary-artery bypass grafting in individuals with triple-vessel or even double-vessel disease. Thus, effort angina needs comprehensive assessment, lifestyle changes, and treatment tailored to the individual patient.

Coronary Artery Disease and Mental Stress
Patients with coronary artery disease (CAD) who have normal exercise- or adenosine-induced stress test results may still develop perfusion deficits when under mental stress. There have been reports of mental stress causing ischemia in CAD patients with exercise-induced ischemia. Positive exercise stress tests are related to major narrowing of epicardial coronary arteries. During mental stress, patients experience a spasm or decreased blood flow in the smaller vessels related to endothelial dysfunction.

Periodontitis and Coronary Artery Disease
Patients with periodontitis, especially infections causing a high concentration of pathogens in the blood, have an increased risk of coronary heart disease. Chronic inflammation from any source iincreases cardiovascular risk and periodontitis is a possible trigger of chronic inflammation. Pathogens that cause periodontal disease may include the following: Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia, and Treponema denticola. There is a significant association between high levels of periodontal pathogen and the presence of coronary artery disease. High levels of A. actinomycetemcomitans antibodies also predict an increased risk of stroke. The Archives of Internal Medicine, March 13, 2006.

Coronary artery disease diagnosis
Stress cardiac magnetic resonance imaging (MRI) "demonstrates overall good sensitivity and specificity for the diagnosis of coronary artery disease.

Racial Differences in Coronary Artery Disease
Racial and ethnic minorities in the United States have a risk for coronary artery disease equivalent to that in the white majority. African Americans have greater cardiovascular mortality rates and greater risk for early mortality caused by coronary artery disease. Risk may be associated with a greater clustering of risk factors in African Americans and other minority groups and may be associated with inadequate screening and evidence-based treatment of these groups in clinical practice. African Americans have a higher level of the inflammatory marker high-sensitivity C-reactive protein than whites.

Coronary artery disease is a type of atherosclerosis in which plaque builds up inside the arteries that carry blood to the heart. As the artery walls thicken, the passageway for blood narrows. Sometimes platelets gather at the narrowing, forming a clot that decreases or prevents blood flow to the region of the heart supplied by the artery. Coronary artery disease is the leading cause of death for both men and women in the United States each year.