CABG (coronary artery bypass graft) - Life after a coronary artery bypass

A coronary artery bypass graft (CABG) is not a cure for heart disease, so it's important to adopt a healthy lifestyle and continue taking any prescribed medication after the operation to reduce the risk of heart problems in the future.

Healthy lifestyle

There are a number of lifestyle changes you can make after having a CABG to help reduce your risk of further heart problems. These are described below.

Healthy diet

An unhealthy diet can increase your chances of developing heart problems after a CABG. To reduce this risk, you should try to eat a diet that is low in saturated fat and salt, but high in fibre and omega-3 (a fatty acid that can help reduce your cholesterol levels).

Examples of foods you should try to avoid include:

• meat pies
• sausages and fatty cuts of meat
• butter, lard and ghee (a type of butter often used in Indian cooking)
• cream
• cakes and biscuits

Instead, you should try to eat foods such as:

• wholegrain rice, bread and pasta
• fruit and vegetables – ideally five portions a day
• oily fish, such as mackerel and sardines

You should also try to cut down on the amount of salt you add to your food and make sure you check the nutrition labels on food when shopping to find products with the lowest levels of salt.

Read more about healthy eating, eating less saturated fat and tips for a lower-salt diet.

Exercise regularly

Once you have fully recovered from the effects of surgery, you should exercise regularly to reduce your risk of further heart problems.

Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity every week. Moderate-intensity means an activity that is strenuous enough to leave you slightly breathless.

Examples of moderate-intensity aerobic activities include:

• walking fast
• riding a bike on level ground or with few hills
• doubles tennis
• pushing a lawn mower
• hiking

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 and the physical activity guidelines for adults.

Lose weight

If you are overweight or obese, you can reduce your risk of further heart problems by trying to reach a healthy weight. Find out if you need to lose weight with the BMI healthy weight calculator.

The best way to lose weight is to follow a healthy diet and exercise regularly (see above). You may find it helpful to follow a structured weight loss plan, such as the free NHS weight loss plan.

Read more about losing weight.

Stop smoking

Smoking can significantly increase your risk of heart problems because it causes your arteries to narrow and raises your blood pressure.

If you want to stop smoking, your GP will be able to refer you to the NHS Smokefree service, which will provide you with dedicated help and advice about the best ways to give up smoking. You can also call the NHS Smoking Helpline on 0300 123 1044. The specially trained helpline staff will offer you free expert advice and encouragement.

If you are committed to giving up smoking but do not want to be referred to a stop smoking service, your GP should be able to prescribe medical treatment to help with withdrawal symptoms you may experience after giving up.

Read more about stopping smoking and stop smoking treatments.

Moderate your alcohol consumption

If you drink alcohol, do not exceed the recommended daily limits of three to four units for men and two to three units for women. A unit of alcohol is roughly half a pint of normal-strength lager, half a standard glass of wine or a single measure (25ml) of spirits.

Regularly exceeding the recommended alcohol limits can raise your blood pressure and cholesterol level, increasing your risk of heart problems.

Read more about alcohol units and tips on cutting down.

Taking medication

Although you will probably need to take less medication after having a CABG, it is likely you will still need to take some to reduce your risk of further problems.

Some of the medications you may be prescribed are described below.

Anticoagulants and antiplatelets

Anticoagulants and antiplatelets are types of medication that reduce the risk of blood clots forming.

Examples of these medications include:

• low-dose aspirin
• clopidogrel
• warfarin

After a CABG, you may be prescribed one of these medications to take for a few months, or for the foreseeable future.

If you are prescribed one of these medications after your operation, it is important to take it because they can reduce your risk of serious problems such as heart attacks.

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 problems such as heart attacks.

Examples of statins include:

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• simvastatin (Zocor)

In most cases, treatment with statins will be recommended for life.

Other medications

Depending on the specific reason why you had a CABG, you may also be prescribed some other medications, such as beta-blockers and angiotensin-converting enzyme (ACE) inhibitors.