A CABG is not a cure for coronary heart disease, so if you don't address the underlying factors that caused your heart disease, your symptoms may return and you may need to have more surgery.
There are five ways you can help reduce your risk of further coronary heart disease:
- Quit smoking (if you smoke).
- Eat a healthy diet.
- Try to lose weight (if you are overweight or obese).
- Drink less alcohol.
- Take regular exercise.
These lifestyle changes are discussed in more detail below.
Smoking
If you smoke, it is strongly recommended that you quit as soon as possible. The NHS Smokefree website can provide you with support and advice. Your GP will also be able to recommend and prescribe medication that can help you give up. Find out more about treatment for quitting smoking.
Diet
It is recommended that you eat two-to-four portions of oily fish a week. Oily fish contains a type of fatty acid known as omega-3. Omega-3 can help to lower your cholesterol levels.
Good sources of omega-3 include:
- herring
- sardines
- mackerel
- salmon
- trout
- tuna
If you are unable or unwilling to eat oily fish, your GP may recommend that you take an omega-3 food supplement.
Never take a food supplement without first consulting your GP. Some supplements, such as beta-carotene, could be harmful.
It is also recommended that you eat a Mediterranean-style diet. This means you should eat plenty of fruit, vegetables and fish, and less meat. Replace butter and cheese with vegetable and plant oils, such as olive oil.
Weight management
If you are overweight or obese, it is recommended that you lose weight and then maintain a healthy weight using a combination of exercise and a calorie-controlled diet. See Treating obesity for more information.
Alcohol
If you drink alcohol, do not exceed the recommended daily limits (no more than three-to-four units a day for men and two-to-three units a day for women). A unit of alcohol is roughly half a pint of normal-strength lager, a small glass of wine or a single measure (25ml) of spirits. Regularly exceeding the recommended alcohol limits will raise your blood pressure and cholesterol level, increasing your risk of coronary heart disease.
Regular physical activity
Once you have fully recovered from the effects of surgery, it is recommended that you do regular physical activity.
Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (i.e. cycling or fast walking) every week.
The level of activity should be strenuous enough to leave you slightly breathless.
If you find it difficult to achieve 150 minutes of activity a week, start at a level that you feel comfortable with (for example, around 10 minutes of light exercise a day) and gradually increase the duration and intensity of your activity as your fitness begins to improve.
Read more about fitness and exercise to get advice about the right levels of exercise for your circumstances.
Medications
It is likely you will be prescribed medications to help reduce your risk of developing coronary heart disease.
Most people are given two types of medications:
- anticoagulants, which are used to prevent blood clots
- statins, which are used to lower cholesterol levels
Anticoagulants
Anticoagulants lower the risk of blood clots forming. They reduce the ability of platelets (small cells in the blood) to stick together.
It is usually recommended that you take low-dose aspirin, which is an anticoagulant as well as being a painkiller.
If you are allergic to aspirin, you can be given an alternative anticoagulant medication called clopidogrel. Side effects of clopidogrel include:
- diarrhoea
- abdominal pain
- indigestion
- heartburn
You usually need to take clopidogrel for four weeks to twelve months. If you are on aspirin, you may need to take this for the rest of your life.
If you are unable to take either aspirin or clopidogrel, you may be prescribed a different anticoagulant called warfarin. Warfarin is usually prescribed for a maximum of four years.
Excessive bleeding is the most serious side effect of warfarin. Seek immediate medical attention if you experience any of the following side effects:
- passing blood in your urine or faeces (stools)
- passing black faeces
- severe bruising
- nosebleeds that last for longer than 10 minutes
- blood in your vomit
- coughing up blood
- unusual headaches
- in women, heavy or increased bleeding during your period or any other bleeding from the vagina
Also seek immediate medical attention if you:
- are involved in major trauma (an accident)
- experience a significant blow to the head
- are unable to stop any bleeding
Statins
Statins are a type of medication used to lower your blood cholesterol level. This will help prevent further damage to your coronary arteries and should reduce your risk of having another heart attack.
Statins sometimes have mild side effects, including:
- constipation
- diarrhoea
- headaches
- abdominal pain
Occasionally, statins can cause muscle pain, weakness and tenderness. Contact your GP if you experience these symptoms, as your dosage may need to be adjusted.
Additional medication
If your CABG was carried out to treat a heart attack, you will be given an additional medication called a beta-blocker. If high blood pressure (hypertension) was thought to be an underlying factor for your coronary heart disease, you may be given a medication called an ACE inhibitor (read more about treating high blood pressure).
