Treatment

The goals of treatment for small vessel disease are to control the narrowing of the small blood vessels that can lead to a heart attack and to relieve pain.

Medications for small vessel disease may include:

• Nitroglycerin (Nitrostat, Nitro-Dur). Nitroglycerin tablets, sprays and patches can ease chest pain by relaxing the coronary arteries and improving blood flow.
• Beta blockers. These drugs slow the heart rate and decrease blood pressure.
• Calcium channel blockers. These drugs relax the muscles around the coronary arteries and cause the blood vessels to open, increasing blood flow to the heart. Calcium channel blockers also help control high blood pressure and coronary artery spasms.
• Statins. These medications help lower bad cholesterol, which contributes to the narrowing of the arteries. Statins also help relax the blood vessels of the heart and treat blood vessel damage.
• ACE inhibitors and ARBs. Drugs called angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) help open blood vessels and lower blood pressure. This makes it easier for the heart to pump blood.
• Ranolazine (Ranexa). This medication eases chest pain by altering sodium and calcium levels.
• Aspirin. Aspirin can limit inflammation and prevent blood clots.
• Metformin. This drug is typically prescribed to lower blood sugar in people with diabetes, but it can improve blood vessel health even in those who don't have diabetes.

If you're diagnosed with small vessel disease, you'll need regular checkups with your health care provider.