Drugs to Treat Atherosclerosis
Other Drugs for Atherosclerosis
Ezetimibe (Zetia) works by reducing absorption of cholesterol in the intestines. It can lower LDL levels. But it doesn’t work as well as statins. This drug is usually used in addition to a statin to further lower bad cholesterol. There is no evidence, though, that it reduces the risk of heart attacks or strokes.
Bile acid sequestrants -- cholestyramine (Questran, Prevalite), colestipol (Cholestid), colesevelam (Welchol) -- bind to bile acids in the intestines. This leads to a lower bile acid level. You need bile, so when that happens, cholesterol must be used to make more. This lowers blood cholesterol levels.
Plant sterols are taken as supplements in pill form or in foods like margarine. Getting plant sterols every day can reduce cholesterol modestly by about 10%.
Lovaza and icosapent (Vascepa) -- both containing omega-3s -- are prescription drugs that can be used with diet to lower high levels of triglycerides.
Drugs to Reduce High Blood Pressure
Lowering blood pressure lowers the risk of atherosclerosis and its complications. Diet and exercise alone don't usually bring high blood pressure down to the safe range. Most people with high blood pressure will require medications (usually at least two) to do the job.
There are many classes of high blood pressure drugs that work in a variety of ways. The choice of medicine isn't as important as the result: getting blood pressure down. Blood pressure should always be less than 140 over 90. For people with atherosclerosis, the goal may be below 130 over 80.
Drugs to Reduce the Risk of Blood Clots
Antiplatelets are blood thinners. They make blood less likely to clot, which can prevent heart attacks and strokes. However, antiplatelets don't slow down or reverse atherosclerosis.
Aspirin: Plain old aspirin is actually a powerful blood thinner. A baby aspirin a day reduces the risk of heart attacks and strokes by 25% or more.
Clopidogrel (Plavix): Clopidogrel acts similar to aspirin. This drug is useful in preventing clots from forming inside stents placed in the heart's arteries.
Ticagrelor (Brilinta): Ticagrelor is similar to clopidogrel. This drug is less effective if patients take more than 100 milligrams a day of aspirin. A "baby aspirin" contains 81 milligrams of aspirin. An FDA "black box" warning tells doctors about the risk of using higher doses of aspirin along with ticagrelor.