If you have been diagnosed with carotid artery disease, unfortunately, you are at greater risk of a first or recurrent stroke. Medications will likely be one key component of treatment, alongside lifestyle changes, whether you are at risk of stroke or have already had one.
The carotid arteries are blood vessels in the neck that supply the brain with oxygen-rich blood. These vessels can become blocked by plaque, a fatty substance consisting of cholesterol, calcium and other materials. Blockages can restrict blood flow and also promote blood clots, which can block the artery entirely. A severe blockage can cause an ischemic stroke, which results when blood flow is cut off and brain tissue begins to die. Less commonly, a hemorrhagic stroke occurs when blood vessels leak and bleed into brain tissue.
The goals of medication will be to reduce plaque build-up in your carotid arteries and blood vessels throughout your body, and to also reduce the likelihood that a blood clot will form elsewhere in your body and travel to a blood vessel in your brain.
Medications for carotid artery disease will primarily consist of the following, along with medications to help control high blood pressure and other cardiovascular risk factors.
Medications Often Prescribed for Carotid Artery Disease
If you are at risk of a first or recurrent stroke, your physician will likely recommend that you take an antiplatelet medication, which helps to prevent excessive clotting. Platelets are cell proteins that circulate in blood and have a role in blood clot formation. Blood clotting is important for wound healing, but blood clots can be deadly if they form or lodge in blood vessels and block blood flow to the heart, lungs or brain. The most common antiplatelet medication that is prescribed is aspirin. Other antiplatelet medications that may be prescribed include clopidogrel (Plavix) or dipyridamole (Persantine).
Anticoagulant medications (“blood thinners”) slow down the blood clotting process by blocking the steps necessary to create a clot. If you have carotid artery disease, a common anticoagulant that is prescribed is warfarin (Coumadin). Warfarin therapy requires frequent monitoring using blood tests to achieve the right amount of anticoagulation. Other oral anticoagulants are also available, some of which do not require frequent blood tests.
Tissue Plasminogen Activator (t-PA)
t-PA is a blood-clot-dissolving medication used to treat an ischemic stroke that is in progress. Patients who receive t-PA within the first three hours after their first symptoms of stroke seem to have a better chance of recovering and have fewer complications.Unfortunately, fewer than 5 percent of patients who have ischemic strokes receive this treatment because they don’t make it to the hospital within that three-hour window during which the treatment is effective or they are they are not diagnosed quickly enough after they arrive.
Taking Your Medication
For medication to be effective it has to be taken exactly as prescribed by your treating physician. If you have difficulty remembering to take your medication or have concerns about side effects or expense, discuss these concerns with your doctor. Never stop taking medication on your own without consulting with your physician; doing so can be dangerous.
Managing carotid artery disease is a lifelong process. If you have been or are being treated for a stroke or “mini-stroke” (an event that is a warning sign of a future stroke with the symptoms of a stroke but that resolves quickly), your physician will likely recommend daily aspirin. You will also be advised to make lifestyle changes such as quitting smoking, adopting a healthy diet and exercising to reduce your risk of future stroke.
Carotid artery disease is a form of cardiovascular disease, as is coronary artery disease - the disease process behind heart attacks. To manage your cardiovascular disease, your physician may prescribe medications beyond those listed here. For more about common medications used to treat cardiovascular disease, click here.
Beyond medications, carotid artery treatment will consist of lifestyle changes, and for severe blockages, in-hospital procedures. Click here to learn more about carotid endarterectomy - surgical removal of the blockage from the artery. Click here to learn more about minimally invasive carotid angioplasty and stenting to restore blood flow through the artery by pushing the blockage aside and propping the artery open.