Learn about the most common heart medications and how they work.
Heart disease is often used as a catch-all term for a host of heart-related ailments. So what exactly is it? Most of us don't understand the most common types of heart disease, the ways our bodies react and the specific ways medication can help.
Who gets heart disease?
According to the American Heart Association, nearly 5 million Americans have heart disease. Almost half a million new cases are diagnosed each year. It is the leading cause of death for both women and men in the U.S. With such sobering numbers, it's important to understand how it is treated and learn how you can work with your doctor to figure out the best medication plan for you or your loved ones.
Dr. Bradley Evans, interventional cardiologist at the Northwest Cardiovascular Institute in Portland, Oregon, says that drugs for heart conditions are classified according to how they work. For the two most common heart conditions, coronary artery disease (also known as vascular disease) and congestive heart failure (also known as cardiomyopathy), doctors usually use several classes of drugs.
Coronary artery disease
"Coronary artery disease is caused by the gradual build-up of plaque inside the arteries that supply oxygen-rich blood to our hearts," Dr. Evans says. Plaque is made up of cholesterol, calcium, fat and other substances found in your blood. "Over a period of years, the plaque hardens, creating a bottleneck effect in the coronary arteries, which limits blood flow to the heart. As an added risk, these areas of plaque may rupture and lead to a blood clot that can completely block blood flow to the heart muscle, causing a heart attack," he adds.
Medicines for coronary artery disease: Antiplatelet agents, statins and ACE inhibitors are the three main kinds of drugs used to treat coronary artery disease. A doctor can prescribe one or more of these kinds of drugs.
- Antiplatelet agents: Drugs like aspirin and clopidogrel (Plavix) reduce blood's ability to clot and help your blood to move through your arteries. If you have a large chance of having a heart attack because you have coronary artery disease, antiplatelet drugs help keep blood moving through your partially blocked or narrowed arteries. Side effects from antiplatelet agents are uncommon. Nausea, stomach pain or ulcers are the side effects most commonly reported.
- Statins: Statins help prevent more heart problems by keeping your arteries from developing more plaque. Drugs like simvastatin (Zocor) and atorvastatin (Lipitor) help lower cholesterol in your blood and reduce the chance that your arteries will get more plaque. The most common side effects for statins are muscle pain, soreness or general muscle tiredness.
- ACE inhibitors: Angiotension-converting enzyme (or ACE) inhibitors help control blood pressure. Drugs like trandolapril (Mavik), enalapril (Vasotec) and lisinopril (Zestril) lower your blood pressure. Lowering blood pressure lets your heart work less hard and reduces the chance of a plaque rupture that can lead to a heart attack. Though side effects from ACE inhibitors are uncommon, you may experience dizziness or get a lingering cough. Your doctor may reduce your dosage to lessen these effects.
Congestive heart failure
Untreated coronary artery disease can lead to congestive heart failure. This failure is the result of your heart not being able to pump enough blood through your body for a long period of time. Blood backs up in other areas of your body, such as your lungs, liver, digestive tract or arms and legs.
Medicines for congestive heart failure: Dr. Evans explains that ACE inhibitors are also used to treat congestive heart failure. But another class of drugs that also controls blood pressure, beta-blockers, can also treat it.
- Beta-blockers: According to Dr. Evans, "Like ACE inhibitors, beta-blockers help control blood pressure, but they do it in a different way. Beta-blockers 'block' the effects of the adrenaline in the body, so patients have a slower pulse and their hearts beat with less force, which reduces blood pressure." Common brands include Sectral, Zabeta and Bystolic. Since beta-blockers can reduce blood flow to your arms and legs, you may get cold hands and feet. More serious side effects are bruising or bleeding easily, or swollen hands or feet. If those side effects happen to you, see a doctor.
Taking a healthy lifestyle to heart
No matter what your heart disease treatment, most heart medications work the same for most patients. "There's no significant difference in how these drugs will perform between the genders or with different races," Dr. Evans explains.
Of course, drugs don't replace a healthy lifestyle. Just because you're taking a pill to lower your blood pressure doesn't mean it's OK to eat a high-salt diet. It's important to exercise, eat right and lower your stress to get the most out of your medicine.
Talking with your doctor
If you have heart disease or have a high chance of getting it, Dr. Evans stresses that you should talk to your doctor about what drugs are being prescribed for you and what they do. "To put it simply, ask questions and understand the answers," Dr. Evans says. "Make your doctor display [the] rationale for choosing a particular drug, and make sure you get the information you need throughout treatment."
Published on Oct. 15, 2011; updated on June 3, 2014.