Heart Medications: Drugs to Treat Heart Disease

Heart disease, also called cardiovascular disease, is a group term for various conditions that affect the heart and blood vessels. These include angina, coronary artery disease, heart attack, heart failure, arrhythmia, valvular heart disease, cardiac arrest, rheumatic heart disease, hypertension, and stroke.

Heart conditions are the leading cause of death globally, claiming an estimated 17.9 million lives every year. However, being diagnosed with a heart condition doesn’t necessarily equal a death sentence.

With medication, heart procedures and surgeries, medical devices, and a heart-healthy lifestyle, one can still lead a long, fulfilling life.

In this article, we’ll discuss some of the most common medications prescribed for heart disease. Usually, your doctor will prescribe more than one drug. And depending on the condition and its severity, you may need to take medications for life.

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What Is Heart Failure?

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What is a Heart Attack?

Common Heart Medications

Types of medicines used to treat heart conditions include:

Angiotensin-converting enzyme (ACE) inhibitors

Examples of ACE inhibitors

• Benazepril (Lotensin)
• Captopril (Acepril, Capoten)
• Enalapril (Innovace, Vasotec)
• Fosinopril (Monopril)
• Lisinopril (Prinivil, Zestril)
• Moexipril (Univasc)
• Perindopril (Aceon, Coversyl)
• Quinapril (Accupril)
• Ramipril (Altace, Lopace)
• Trandolapril (Gopten, Mavik)

What do ACE inhibitors do?

ACE inhibitors slow or inhibit the activity of the angiotensin-converting enzyme, reducing the production of angiotensin II.

As a result, your blood vessels dilate, lowering blood pressure and improving the flow of blood. Your heart health consequently improves as it doesn’t have to work hard to pump blood.

Why are ACE inhibitors prescribed?

Your doctor will likely prescribe an ACE inhibitor if you have heart failure, have experienced a heart attack, or have high blood pressure (hypertension).

Angiotensin II receptor blockers (ARBs)

Examples of angiotensin II receptor blockers

• Azilsartan (Edarbi)
• Candesartan (Atacand)
• Eprosartan (Teveten)
• Irbesartan (Avapro)
• Losartan (Cozaar)
• Olmesartan (Benicar)
• Telmisartan (Micardis)
• Valsartan (Diovan)

What do angiotensin II receptor blockers do?

ARBs block the action of angiotensin II on your heart, kidney, and blood vessels. The hormone causes sodium and water retention and vasoconstriction, i.e., the narrowing of blood vessels.

Therefore, ARBs cause your arteries and veins to widen, lowering your blood pressure and your heart’s workload.

Why are angiotensin II receptor blockers prescribed?

Doctors typically prescribe ARBs to people with hypertension, heart failure, and chronic kidney disease.

Angiotensin Receptor-Neprilysin Inhibitors (ARNIs)

Examples of ARNIs

• Entresto (valsartan/sacubitril)

What do ARNIs do?

Angiotensin receptor-neprilysin inhibitors contain a neprilysin inhibitor and an angiotensin receptor blocker.

ARNIs, therefore, prevent angiotensin II from having any effect and cause natriuretic peptide levels to rise.

Consequently, the drugs cause your blood vessels to relax, improving blood flow, which relieves the strain on your heart. ARNIs also increase sodium and water excretion through natriuresis.

Why are angiotensin receptor-neprilysin inhibitors prescribed?

ARNIs are a new class of drugs for heart failure treatment.

Anticoagulants (blood thinners)

Examples of anticoagulants

• Apixaban (Eliquis)
• Dabigatran (Pradaxa)
• Edoxaban (Savaysa)
• Heparin
• Rivaroxaban (Xarelto)
• Warfarin (Coumadin, Jantoven)

What do anticoagulants do?

Anticoagulants prevent the formation of blood clots and prevent already existing clots from growing.

Why are anticoagulants prescribed?

Your doctor may prescribe blood thinners if you have Atrial fibrillation (an irregular heart rhythm), artificial heart valves, and congenital heart defects.

Your doctor may also recommend treatment with anticoagulants to prevent a first or repeat heart attack or stroke.

Antiarrhythmic medicines

Examples of antiarrhythmic drugs

• Digoxin (Lanoxin)
• Amiodarone (Cordarone, Pacerone)
• Flecainide (Tambocor)
• Propafenone (Rythmol)
• Sotalol (Betapace)
• Anticoagulants
• Calcium channel blockers
• Beta-blockers

What do antiarrhythmic drugs do?

Antiarrhythmic drugs help control heart rate and heart rhythm. They also prevent and treat blood clots hence help prevent stroke and heart attack.

Why are antiarrhythmic drugs prescribed?

Medications for arrhythmia are prescribed to people whose heart beats too fast (tachycardia), too slow (bradycardia), or with an irregular rhythm (atrial fibrillation).

Antiplatelet agents

Examples of antiplatelet agents

• Aspirin (Easprin, Ecotrin, Genacote, Ninoprin)
• Clopidogrel (Plavix)
• Dipyridamole (Persantine)
• Prasugrel (Effient)
• Ticagrelor (Brilinta)

What do antiplatelet agents do?

Antiplatelets prevent blood clots from forming, which prevents arteries and stents from becoming narrowed. They achieve this by preventing the platelets in your blood from sticking together to form a clot.

Some patients receive dual antiplatelet therapy (DAPT), i.e., treatment using aspirin plus another antiplatelet agent.

Why are antiplatelet agents prescribed?

Your doctor may prescribe an antiplatelet agent if you have had a heart attack, peripheral vascular disease, ischemic stroke, unstable angina, among other cardiovascular diseases.

Antiplatelet agents are also used to prevent heart attack and other conditions that may result from plaque buildup in your coronary arteries.

Beta-blockers (beta-adrenergic blocking agents)

Examples of beta-blockers

• Acebutolol (Sectral)
• Atenolol (Tenormin)
• Betaxolol (Kerlone)
• Bisoprolol (Zebeta)
• Metoprolol (Lopressor, Toprol XL)
• Nadolol (Corgard)
• Nebivolol (Bystolic)
• Propranolol (Inderal, InnoPran XL)
• Sotalol (Betapace)

What do beta-blockers do?

Beta-blockers block the action of the hormone adrenaline (epinephrine), which reduces your heart rate and heart’s pumping force, thereby lowering your blood pressure.

Why are beta-blockers prescribed?

Doctors prescribe beta-blockers to treat angina (chest pain), heart failure, cardiac arrhythmias, and high blood pressure.

These medications also help protect against a second heart attack in people who have suffered a heart attack before.

Calcium channel blockers

Examples of calcium channel blockers

• Amlodipine (Norvasc)
• Diltiazem (Cardizem, Tiazac)
• Felodipine (Plendil)
• Nifedipine (Adalat CC, Procardia)
• Nimodipine (Nimotop)
• Nisoldipine (Sular)
• Verapamil (Calan, Verelan)

What do calcium channel blockers do?

Calcium channel blockers block calcium from entering your heart and blood vessel cells, causing your blood vessels to relax and blood flow to the heart muscle to improve. The reason being calcium increases cardiac contractility.

Why are calcium channel blockers prescribed?

Calcium channel blockers are used to lower high blood pressure, relieve chest pain, and correct abnormal heart rhythms.

Cholesterol-lowering medications (lipid-lowering medicines)

Examples of cholesterol-lowering medications

• Statins: Atorvastatin (Lipitor), Fluvastatin (Lescol), Lovastatin (Altoprev), Pitavastatin (Livalo,Zypitamag), Pravastatin (Pravachol), Rosuvastatin (Crestor, Ezallor), and Simvastatin (Zocor)
• Cholesterol absorption inhibitor: Ezetimibe (Zetia)
• Combination cholesterol absorption inhibitor and statin: Ezetimibe/Simvastatin (Vytorin)
• Niacin (nicotinic acid): Prescription niacin (Niacor, Niaspan)
• PCSK9 inhibitors: Alirocumab (Praluent), Evolocumab (Repatha)

What do cholesterol-lowering medications do?

Like the name suggests, cholesterol-lowering medications lower your levels of LDL “bad” cholesterol, which increases your risk of heart attack and stroke. Statins are the first-line treatment for high cholesterol levels.

Doctors only prescribe other cholesterol-lowering medications if statins are proved ineffective or cause severe side effects. Statins work by reducing the amount of cholesterol your liver produces.

Why are cholesterol-lowering drugs prescribed?

Your doctor will prescribe a statin if you have high LDL cholesterol levels, have had a heart attack or stroke, or are at an increased risk of developing heart disease.

Digitalis Preparations

Examples of Digitalis Preparations

• Digoxin (Lanoxin)

What does digoxin do?

Digoxin strengthens your heart’s pumping action, allowing it to efficiently pump blood to the rest of your body, which, in turn, slows the heart rate.

Why is digoxin prescribed?

Doctors prescribe digoxin to treat abnormal heart rhythms, particularly atrial fibrillation. Digoxin also helps relieve heart failure symptoms by improving heart function.

However, doctors first prescribe more standard heart failure medications like beta-blockers, ACE inhibitors, and ARBs.

Diuretics (water pills)

Examples of diuretics

• Amiloride (Midamor)
• Bumetanide (Bumex)
• Chlorothiazide (Diuril)
• Furosemide (Lasix)
• Hydrochlorothiazide (Esidrix, Microzide)
• Indapamide (Lozol)
• Metolazone (Zaroxolyn)
• Spironolactone (Aldactone, Carospir)
• Torsemide (Demadex)
• Triamterene (Dyrenium)

What do diuretics do?

Diuretics promote diuresis, i.e., increased urine production, which results in the excretion of excess sodium and water.

As a result, the amount of fluid flowing through the blood vessels reduces, lowering blood pressure.

Why are diuretics prescribed?

Diuretics are one of the first-line drugs for hypertension (high blood pressure). They also help improve symptoms in patients with heart failure.

Nitrates

Examples of nitrates

• Isosorbide dinitrate (Isordil)
• Isosorbide mononitrate (Imdur)
• Nitroglycerin

What do nitrates do?

Nitrates dilate the blood vessels in your heart and the rest of the body, improving blood flow to the heart and reducing its workload.

This, in turn, relieves chest pain (angina), which occurs as a result of the heart muscle not receiving enough oxygenated blood.

Why are nitrates prescribed?

Your doctor will usually prescribe nitrates to relieve or prevent angina. He/she will determine which formulation is best for you from the following options: oral pill, sublingual tablet, sublingual spray, patch, and topical cream.

Learn About Your Heart Medication

If your doctor has prescribed heart medication, knowing as much as you can about it is crucial. For instance, you can ask your doctor about:

• The name and type of the heart medication and why you should take it
• How to take it
• When to take it
• How long you’ll be on the treatment
• Possible side effects and what to do when you experience them
• Prescribed medications, over-the-counter drugs, natural remedies, or supplements you can’t take while using the medication
• How to store the medication
• Whether you can drive while on the medication

How Are Heart Medicines Taken?

Heart medications come in many forms. You can take them:

• Orally or sublingually: tablets and capsules are swallowed with water, dissolved in water, or put under your tongue to dissolve. Some heart medications come in the form of an aerosol spray, where you spray the medicine under your tongue.
• Intravenously: medication is either injected directly into your vein or delivered through an IV drip.
• Topically: for heart medication in patch or cream form, you’ll need to apply the medicine to your skin.
• Subcutaneously: some drugs for heart treatment require injecting into the fatty tissues just under your skin.
• Intramuscularly: the heart medication is administered into a muscle.

Will My Medicine Cause Side Effects?

All medications can sometimes cause side effects. However, you may not experience any side effects. And even if you do, they’ll usually not last.

Do, however, ensure to notify your doctor of any side effects you notice. He/she may adjust your dose or change your medication entirely. But never stop taking your heart medication without your doctor’s go ahead.