Heart Disease Medicine: How Can It Help You?

Anticoagulants

Anticoagulants are sometimes called "blood thinners." This type of heart disease medicine helps prevent clots from forming in your blood vessels. This can help prevent a heart attack or stroke, which are often caused by clots. However, anticoagulants can't make some of these existing clots go away.

Examples of anticoagulants include: 

 

 

 

 

Antiplatelet Agents

This type of heart disease drug also helps prevent clots from forming in blood vessels. It accomplishes this by preventing blood platelets from clumping together.

Your doctor may prescribe antiplatelet medication in these cases:

  • You have had a heart attack
  • You have unstable angina
  • You have had strokes, including TIAs (transient ischemic attacks)
  • You have another type of heart disease
  • Your doctor has noted plaque buildup in the blood vessels of your legs
  • You are at high risk for heart attack or stroke
  • You have had atrial fibrillation

Examples of antiplatelet medicine include:

 

Some people may not be able to take antiplatelet medications if they are at risk for bleeding.

Alpha-Blockers

Alpha-blockers can help lower your blood pressure. They do this by reducing nerve impulses that tell your vessels to tighten. Your blood vessels remain relaxed, lowering your overall blood pressure. Doxazosin (Cardura) and prazosin (Minipress) are two examples of the many alpha-blockers.

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Angiotensin-Converting Enzyme (ACE) Inhibitors

This type of heart disease medicine can help in these ways:

  • Lower blood pressure
  • Make the heart's work easier
  • Help the heart work more efficiently
  • Improve the heart's function if you have heart failure
  • Protect the kidneys, especially in people with diabetes

Here's how ACE inhibitors work: They prevent your body from making angiotensin II. Angiotensin II is a hormone that makes blood vessels tighten. Because ACE inhibitors lower the amount of this hormone in your body, your blood vessels remain relaxed. Blood flows more easily through the vessels, lowering your overall blood pressure. Your heart doesn't have to work so hard to pump blood through your vessels.

Examples of ACE inhibitors include:

 

 

Angiotensin II Receptor Blockers (ARBs)

This type of heart disease medicine can have these effects:

  • Lower your blood pressure
  • Ease the work of your heart

ARBs block the action of angiotensin II, a hormone that makes blood vessels tighten. As a result, blood vessels remain relaxed. Blood flows more easily through the vessels. Your blood pressure becomes lower and your heart has to work less to pump blood through them. You may also use an ARB if you cannot tolerate ACE inhibitors due to a cough, a common side effect.

Examples of ARBs include: 

 

Beta-Blockers

This type of heart disease medicine can help in these ways:

  • Makes your heart beat more slowly
  • Makes the heart beat with less force
  • Lowers your blood pressure
  • Helps prevent future heart attacks if you have already had one
  • Relieves chest pain
  • Helps your heart beat more steadily

How do beta-blockers accomplish all this? They prevent the hormone adrenaline from working. When adrenaline is blocked, your heartbeat slows down. Your heart can't pump so hard. This makes blood go through your vessels with less force. The pressure inside your blood vessels drops. Your heart works less.

Examples of beta-blockers include: 

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Calcium Channel Blockers (CCBs)

This type of heart disease drug is also called a calcium antagonist. CCBs can have these effects:

  • Lower your blood pressure
  • Reduce chest pain (angina)
  • Help lower heart rate

How do calcium channel blockers accomplish this? CCBs prevent calcium from entering the muscle cells in your heart and blood vessels. This keeps blood vessels from tightening so much and causes the heart to pump with less strength. Your heart rate slows and blood can flow more easily through the vessels. This lowers blood pressure.

Examples of CCBs are:

 

 

Angiotensin receptor-neprilysin inhibitors (ARNIs)

This is a new class of drug approved in 2015. Entresto (sacubitril/valsartan), a combination of a neprilysin inhibitor and ARB, has been found to reduce both the risk of death as well as hospitalization in general for those suffering from chronic heart failure. This medication helps in these ways:

  • Allows your heart to pump blood more efficiently
  • Helps your heart beat more steadily
  • Makes heart beat more slowly
  • Lowers blood pressure
  • Relieves chest pain
  • Reduces stress on the heart

 Side effects for this drug includes:

  • Low blood pressure
  • High blood potassium levels
  • Kidney impairment

Cholesterol-Lowering Drugs

Cholesterol-lowering drugs can:

Cholesterol-lowering drugs work in a variety of ways to improve heart health. Some change the way the liver processes cholesterol and fat. Others affect the way your body digests nutrients. Still others prevent cholesterol from flowing through your blood vessels.

Your doctor may prescribe one or a combination of cholesterol-lowering drugs. Examples include:

  • Statins lower LDL (''bad'') cholesterol levels and keep cholesterol from forming in your blood vessels.
  • Fibrates, such as gemfibrozil ( Lopid) raises HDL (''good'') cholesterol levels.
  • Nicotinic acid (niacin) lowers triglycerides and LDL cholesterol and raises HDL cholesterol levels.
  • Resins (bile acid-binding drugs) help intestines dispose of cholesterol.
  • Cholesterol absorption inhibitor ezetimibe (Zetia) limits absorption of cholesterol in your digestive tract.
  • Proprotein Convertase Subtilisin Kexin Type 9 (PCSK9) Inhibitors. Proprotein Convertase Subtilisin Kexin Type 9 (PCSK9) Inhibitors.This is a new class of cholesterol lowering drugs which is used in patients who cannot control their cholesterol through diet and statin treatments. The drugs block the liver protein PCSK9 which hinders the liver’s ability to remove LDL-cholesterol from the blood. In doing so, it can dramatically reduce the amount of bad cholesterol in the bloodstream.

A PCKS9 inhibitor can be effective in adult patients with the inherited disease heterozygous familial hypercholesterolemia (HeFH) or for patients with atherosclerosis, whose cholesterol can not be controlled on other meds and who are in danger or heart attack or stroke.

 Evolocumab has actually proven to significantly lower the risk of a heart attack or stroke in people who have been diagnosed with cardiovascular disease.

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Combined Alpha- and Beta-Blockers

This type of heart disease medication helps lower blood pressure. It does this by slowing your heart rate and reducing nerve impulses that tell vessels to tighten.

Examples of combined alpha- and beta-blockers include carvedilol (Coreg) and labetolol.

Digitalis Drugs

This type of heart disease medicine can be helpful in these cases:

Digitalis drugs work by making your heart beat stronger and can help slow down heart rate. Digoxin (Lanoxin) is one example of a digitalis drug.

Diuretics

Diuretics are often called "water pills." Diuretics can help your heart in these ways:

  • Lower blood pressure
  • Reduce swelling from extra fluid buildup throughout your body
  • Relieve the heart's workload

Here's how they work: Diuretics help your kidneys remove sodium and water from the body. One of the results is that you have less blood volume circulating in your blood vessels. Less blood volume in the vessels leads to lower blood pressure.

Diuretics are sometimes the first type of medicine that your doctor will try if you have high blood pressure. Examples of diuretics include: 

  • Bumetanide
  • Furosemide (Lasix)
  • Hydrochlorothiazide or HCTZ
  • Potassium-sparing diuretics: amiloride (Midamor), eplerenone (Inspra), spironolactone (Aldactone) and triamterene (Dyrenium), 
  • Torsemide (Demadex)

Some diuretics are combined in one pill with other heart medications.

Selective sinus node inhibitors

This new class of drug targets a specific area of the heart, the sinoatrial pacemaker, which affects heart failure.  These drugs:

  • Regulate the pacemaker cells of the heart
  • Lower the heart rate

Ivabradine (Corlanor) is used in patients whose heart muscle is not contracting well.

Central Acting Agents

This type of heart disease medicine helps lower blood pressure.

Central acting agents keep your brain and central nervous system from sending too many nerve impulses that tell the vessels to tighten. As a result, blood vessels remain wider. This helps lower your blood pressure.

They can also be called "central adrenergic inhibitors." Clonidine (Catapres) is an example of a central agonist. 

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Vasodilators

Your doctor may prescribe vasodilators if you haven't been able to tolerate ACE inhibitors. Vasodilator heart disease medicine has two effects:

  • Lowers blood pressure
  • Eases chest pain (angina)

Vasodilators relax the muscles in the blood vessel walls. The vessels widen and blood flows through more easily. Your blood pressure lowers. Your heart receives more blood and oxygen, so it doesn't have to work so hard to pump.

Examples of vasodilators include:

Finding the Right Combination of Heart Disease Medication

Which medications may be best for you? That depends on factors such as these:

  • The causes of your heart disease
  • How your body responds to different drugs
  • Any other health problems you might have
  • Other medications you are taking

It may take some trial-and-error testing to find the combination of heart disease medicine that works best for you. Many people need more than one type of drug in order to get the best results. Some of these medications are combined into one pill.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on January 08, 2018

Sources

SOURCES: 

 

News release, FDA. 
American Academy of Family Physicians: "Blood Pressure Medicines and High Blood Pressure: Things You Can Do to Help Lower Yours." 
American Heart Association: "Cardiac Medications At-a-glance;" "Cholesterol-lowering Drugs;" and "Taking Medication for High Blood Pressure." 
National Heart Lung and Blood Institute: "High Blood Pressure." 
National Library of Medicine. 
MedlinePlus Drugs, Supplements and Herbal Information.

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