Date of Award

2024

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Carr, Kristen

Keywords

Coronary artery disease; plaque accumulation; statin therapy; atorvastatin; plant-based diet; LDL reduction

Abstract

Coronary artery disease is one of the most common chronic health conditions to affect adults in the United States, with heart disease being the leading cause of death. Contributing factors include high prevalence of processed foods containing saturated fats, low fiber diets and poor overall nutrition, and physical inactivity. These practices increase risk of low-density lipoprotein cholesterol (LDL-C) plaque buildup and calcification within arteries that supply the heart, leading to decreased blood flow and subsequent oxygen supply. Treatment for coronary artery disease has traditionally been dominated by HMG CoA-reductase inhibitors, or statins. These medications are more effective than the alternative therapy medications called fibrates, and more affordable than the injectable cholesterol medication class of PCSK9 inhibitors. To determine other possible treatment options for reducing plaque buildup, a literature review was completed using retrospective and case/control studies that emphasized specific dietary changes and exercise regimens. Many participants have hesitations about statin therapy due to side effects including myalgias and arthralgias. The results of this review confirm that statin therapy remains an effective treatment for stabilization of low-density lipoprotein plaques. Additionally, specific, and consistent dietary modifications can contribute to slowed progression of disease. Primary motivation for treatment resistance was also evaluated in this literature review.

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