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As in preventing heart disease (coronary heart disease); two measures are of primary importance in its treatment:

FOLLOW HEALTHY LIFESTYLE
Eat healthy, lose weight if you are obese or overweight, be physically active (after consulting your doctor), and avoid smoking.

MODIFY THE RISK FACTORS
As in preventing heart disease,the first step in its treatment is to control the risk factors. This means, for example, that you should control your blood sugar, blood pressure, and blood cholesterol.

When nutrition, lifestyle modifications, and management of other risk factors fail to control heart disease, the doctor may add medicines. In extreme cases, surgery may be required to clear blockages in the coronary arteries. However, keep in mind that a healthy lifestyle is of primary importance in preventing and treating heart disease. Even when heart disease is treated with drugs or surgery, a healthy lifestyle must remain in place or the benefits of treatment will be lost.

DRUG TREATMENT
There are no drugs that can directly reverse heart disease. Drugs are given for relieving the symptoms of angina, and to reduce the risk of heart attack. These drugs include:

Nitroglycerin
Nitroglycerin dilates coronary arteries temporarily. The dilation allows an increased amount of blood and oxygen to pass through the blocked arteries, an effect that relieves angina and lowers high blood pressure. Nitroglycerin medications are available in two forms: quick-acting and long-acting. The quick-acting nitroglycerin includes nitroglycerin tablets for use under the tongue (sublingual) or in the cheek (buccal), and sublingual sprays. These medications are used to treat angina that has already occurred. The long-acting nitroglycerin, on the other hand, is used to prevent angina from occurring, which include: isorbide dinitrate and sorbide mononitrate tablets or capsules for swallowing, and ointment and time released medicated patches for application to the skin. Because constant use of nitroglycerin tends to lessen its effect in the body, give a gap of at least 8 to 12 hours in its use during every 24 hours to get good results.

Blood Pressure-Lowering Drugs
Blood pressure-lowering drugs belonging to the classes of beta-blockers and calcium channel blockers reduce the heart’s need for oxygen during physical activity.  Such an effect helps prevent the onset of angina and reduce its intensity if it occurs.

Heart Protective Medicines
Several heart protective medicines such as aspirin, clopidogrel (Plavix), ACE inhibitors (such as enalapril, ramipril), and ARBs (such as  losartan) are available.
Aspirin and clopidodrel (Plavix) help prevent the formation of blood clots, an action that reduces the risk for heart attack. Regular use of low strength aspirin, 75 to325 mg per day, has been shown to reduce the risk for heart attack and stroke.

ACE inhibitors and ARBs (noted abovel) are drugs that provide heart protective effect by blocking the production of a hormone called angiotensinII. (Excess of angiotensinII contributes to formation of blockages and weakening of heart muscle.)

A study published in the British Medical Journal suggests that preventive medication can reduce the risk for heart attack and stroke by more than 80 percent. The doctor will decide if you are a candidate for such treatment; if yes, he or she will choose a drug that will be right for you

Cholesterol-Lowering Drugs
Strong evidence is emerging that when raised LDL (bad) cholesterol is treated with strong doses of cholesterol-lowering medicines of the “statin” class (such as Lipitor, Zocor), blockages in the coronary arteries decrease. Such a reduction in clogging helps reduce the risk of heart disease.

HEART SURGERY
Angina not relieved by life-style changes, nutrition, and drug therapy is a sign that coronary heart disease has already become fairly severe. In such situations, surgery may be the only option left for treatment of angina. Before performing heart surgery, the doctor orders an angiogram to find out the location and the extent of blockages in the coronary artery or arteries.

Surgery options may include procedures such as balloon angioplasty or coronary stenting or both, or bypass surgery. (To be discussed in detail later).
Today, technological advances made in these procedures have brought a revolution in heart disease treatment.