Find diet, exercise, and other strategies to help prevent and manage coronary artery disease in the Prevention section.

In addition to lifestyle changes, your healthcare provider may recommend medications or surgery.

Medications 

Cholesterol-modifying Drugs

Several medicines can raise “good” HDL cholesterol and lower “bad” LDL cholesterol in the blood. This helps reduce plaque buildup in the coronary arteries.

• Statins block a substance in the liver that makes cholesterol. Common statins include atorvastatin (Lipitor), lovastatin (Mevacor), rosuvastatin (Crestor), and simvastatin (Zocor).
• Fibric acid drugs, also called “fibrates,” are used when triglycerides (a type of fat in the blood) are high along with high “bad” LDL cholesterol.

Blood Thinners

Blood thinner pills include two main types: antiplatelet drugs and anticoagulants. They help prevent blood clots in different ways.

• Aspirin is commonly used to treat coronary artery disease. The dose may range from one “baby” aspirin (81 mg) to one regular-strength (325 mg) tablet per day.
  • Aspirin is not usually recommended for prevention unless a person already has coronary artery disease or another type of blood vessel disease.
  • Common side effects include stomach upset, ulcers, and bleeding. Coated aspirin may reduce stomach irritation. However, people with a history of heart disease may be advised to keep full-strength aspirin available in case of a heart attack.
• Other antiplatelet drugs used for heart disease include clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta).

• Anticoagulant medicines include warfarin (Coumadin) and newer oral anticoagulants such as rivaroxaban (Xarelto), dabigatran (Pradaxa), and apixaban (Eliquis).

  These medicines work in different ways to thin the blood and prevent clots. A person may take them along with aspirin or another antiplatelet drug. It is very important to take these medicines exactly as prescribed. Missing even one dose can increase the risk of a blood clot.

  Because these medicines can cause serious bleeding, they are considered high-risk medications for older adults (see the AGS Updated Beers Criteria). Healthcare providers should monitor older adults closely, especially those with kidney disease. Always bring a complete medication list to all medical appointments so each provider knows which medicines you are taking.

Nitroglycerin

Nitroglycerin relaxes and widens the blood vessels in the heart so more blood can flow to the heart muscle. This helps relieve chest pain and may make breathing easier.

Nitroglycerin tablets are usually placed under the tongue so the medicine enters the bloodstream quickly. Nitroglycerin is also available as a cream, patch, or spray.

Because fainting and headaches can occur, sit down before taking nitroglycerin.

Some medications can interact with nitroglycerin and cause blood pressure to drop to dangerous levels. Tell your healthcare provider about all medications you take, even those you think are harmless. This includes medications for erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis), and similar drugs.

If you call 911 or go to the emergency room for chest pain, tell the medical team if you have used any of these medications in the past few days.

Blood Pressure Medications

Treating high blood pressure can:

• Reduce angina pain
• Lower the risk of heart attack and other conditions, such as stroke and kidney disease 

Blood pressure is usually treated if it is higher than 140/90 mmHg. Lower targets may be recommended for people with diabetes, chronic kidney disease, or other long-term health conditions. The best blood pressure goal for an older adult depends on overall health and should be discussed with a healthcare provider.

Ask your healthcare provider about possible side effects of your medications. Tell them if you experience any side effects. Do not stop taking medications without speaking to your provider first. Stopping certain medications suddenly can be dangerous and may worsen your condition.

Surgery

Severely narrowed coronary arteries may require surgery to prevent a heart attack. 

Angioplasty and Stent Placement 

This procedure is also called percutaneous coronary intervention (PCI). A healthcare professional inserts a small deflated balloon through a thin tube into the blocked coronary artery. When the balloon is inflated, it opens the blockage. A small wire mesh tube called a stent is often left in place to help keep the artery open. Some stents slowly release medication to help prevent the artery from narrowing again.

Coronary Bypass Surgery

In this surgery, a new blood vessel is connected (grafted) to the blocked artery. The graft is attached just before and just after the blockage. This allows blood to flow around the blocked area. The graft is often a vein taken from another part of the body.

Because this is open-heart surgery, it is usually recommended when several coronary arteries are blocked.

Side effects of bypass surgery can include:

• Cognitive impairment (changes in memory or thinking)
• Functional decline (loss of independence in self-care)

It may take several months to return to previous abilities after surgery. To reduce problems:

• Rehabilitation should begin in the hospital as soon as possible after surgery.
• The person should take part in a structured cardiac rehabilitation program after leaving the hospital, if possible.

Complications of Coronary Artery Disease 

Chronic Stable Angina

A person with coronary artery disease may have chest pain (angina) when the heart muscle needs more oxygen. With stable angina, a person can usually recognize what triggers the pain. They can adjust their activity. For example, slowing down or stopping exercise may cause the pain to improve and go away.

The causes of stable angina usually include:

• Strenuous physical activity
• Large meals
• Cold weather
• Severe emotional stress

Angina pain usually lasts only a few minutes. Nitroglycerin or another medication can relieve the pain.

If you have chronic stable angina, notify your doctor if you:

• Have angina more often
• Have angina while resting
• Feel tired more often
• Feel dizzy or faint
• Notice your heart skipping beats or beating very slowly or very fast

Heart Attack (also called myocardial infarction, or MI)

(Also see Heart Attack information in the Causes and Symptoms section.)

If you think you are having a heart attack, call 911 immediately. The first minutes to hours are critical for preventing death. Getting treatment quickly can greatly reduce damage to the heart muscle and improve recovery.

While waiting for the ambulance, chew one non-coated, full-strength (325 mg) aspirin tablet or three baby aspirin. This helps thin the blood and reduce clot formation. Tell the emergency room doctor that you have already taken aspirin so you do not receive another dose.

An emergency room doctor may give “clot-busting” medication to dissolve blood clots during or shortly after a heart attack. A heart specialist may also recommend an emergency procedure (angioplasty) to open a blocked artery.

Because of improved treatments and better awareness of symptoms, most people survive heart attacks. With treatment and cardiac rehabilitation, many people return to full and active lives.

Heart Attacks in Women

Women may have different symptoms of a heart attack than men. Although chest pain is still common, it may be milder or may not occur at all in women.

Women are more likely to have pain in the jaw or back, or other symptoms. They may experience shortness of breath, nausea, vomiting, or anxiety.

Most heart attacks in women occur after menopause. After menopause, estrogen levels decrease. Lower estrogen levels can increase “bad” LDL cholesterol, which raises the risk of heart disease.

Last Reviewed and Updated: August 2026 
By: AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers