Managing heart disease

Along with lifestyle changes, as described in "Preventing heart disease," medications are often prescribed to treat certain types of heart disease or risk factors for heart disease.

The following groups of medications can be used to treat or prevent heart disease. The medications that are prescribed for you will depend on the type of heart disease you have, your heart disease risk factors, other medications you are taking, and your other medical problems.

ACE inhibitors, also known as angiotensin-converting enzyme inhibitors (e.g., enalapril, lisinopril, ramipril, trandolapril), are a group of medications that can be used to treat high blood pressure and heart failure. ACE inhibitors help to relax and widen blood vessels. This lowers blood pressure and makes it easier for the heart to pump blood.

Angiotensin II receptor blockers, or ARBs for short (e.g., candesartan, losartan valsartan), are also used to treat high blood pressure and heart failure. This group of medications works by lowering blood pressure and making it easier for the heart to pump blood.

Antiarrhythmics such as amiodarone, dronedarone, sotalol, propafenone, flecainide, and procainamide are used to treat abnormal heart rhythms. They work by changing how electrical impulses affect the heart muscle and making the heart beat more regularly.

Anticoagulants (e.g., warfarin, heparin, dabigatran) are often referred to as "blood thinners," but they do not actually thin the blood. They actually decrease the ability of your blood to form clots and can reduce your risk of a heart attack or stroke, or of a clot forming in a heart valve. Anticoagulants may be prescribed if you have had a heart attack or a stroke, have an artificial heart valve, or have certain types of abnormal heart rhythms (e.g., atrial fibrillation).

Antiplatelets are medications that decrease the ability of platelets to stick together. Since platelets are a major component of blood clots, antiplatelets such as acetylsalicylic acid (ASA), clopidogrel, and dipyridamole help to reduce the risk of a blood clot forming that could cause a heart attack or stroke. Antiplatelets may be prescribed if you have had a heart attack or a stroke, or have had a stent (a small mesh tube used to keep arteries open) placement.

Beta-blockers (e.g., atenolol, bisoprolol, carvedilol, metoprolol) are a group of medications that are used to treat high blood pressure, heart failure, abnormal heart rhythms, and angina. They can also be used to help prevent a second heart attack. Beta-blockers work by slowing the heart rate and reducing the work your heart needs to do to pump blood.

Calcium channel blockers (e.g., amlodipine, verapamil, diltiazem) are a group of medications that are used to treat high blood pressure, certain types of abnormal heart rhythms, and angina (chest pain). They work by widening blood vessels and reducing blood pressure. Some calcium channel blockers slow the heart rate so the heart doesn't work as hard.

Cholesterol-lowering medications may be recommended by your doctor if you have high cholesterol or have a high risk of heart disease. Medications used to lower cholesterol include the "statins" (e.g., atorvastatin, lovastatin, simvastatin), resins (e.g., cholestyramine, colestipol), fibrates (e.g., fenofibrate, gemfibrozil), cholesterol absorption inhibitors (e.g., ezetimibe), and niacin. Cholesterol-lowering medications have been shown to lower the chance of further clogging of the arteries by lowering levels of LDL (bad) cholesterol or raising the levels of HDL (good) cholesterol.

Digoxin can be used to treat heart failure or an abnormal heart rhythm called atrial fibrillation. It works by helping improve how well the heart pumps blood or by slowing down the heart rate.

Direct renin inhibitors (e.g., aliskiren) are used to treat high blood pressure. They work by blocking the action of renin, a chemical in the body that causes blood vessels to constrict.

Diuretics (e.g., hydrochlorothiazide, furosemide, indapamide, spironolactone), also called "water pills," are used to treat high blood pressure or heart failure, usually along with other medications. They work on the kidney to help it produce more urine in order to get rid of extra fluids in the body.

Vasodilators (e.g., nitroglycerin, isosorbide, hydralazine) can be used to treat angina and heart failure. Vasodilators open blood vessels to improve blood flow to the heart muscle and also reduce the workload on the heart.

The medications that your doctor prescribes will depend on the type of heart disease you have, other medical problems you have, and other medications you are taking. Ask your doctor about the risks and benefits of the medications they prescribe and ask any questions you have about side effects and what to expect with treatment.

Be sure you let all of your health care professionals know what medications you are taking - this will help avoid potentially serious drug interactions and help ensure you get the best treatment possible.

Be sure to use the Doctor Discussion Guide so that you will be better able to talk with your doctor about a particular treatment plan that meets your needs.