Top 5 recommended heart medications — and what you should know about them
Heart disease has been around for thousands of years, but knowledge and treatment options surrounding this disease were limited. For a long time, medication was not an option at all.
In roughly the past six decades, however, not only has medication become a primary treatment approach for heart disease, but there are also options for what kind of medication you take.
"If you have heart disease now, this means you have choices about what medication works best for you, allowing you to prevent heart attacks and strokes as well as improve your quality of life," says Howard Kramer, MD, a cardiologist at Bryn Mawr Hospital, part of Main Line Health.
Here are the top 5 recommended heart medications and what you should know about them.
1. Cholesterol-lowering medication, like statins
Dating back to 1987, statins come in seven different medications. Statins are used to lower LDL cholesterol — or the "bad&" cholesterol — by up to 60%. They also reduce inflammation in your artery walls, avoiding blockages that can prevent blood flow to your heart or brain.
Statins provide a major benefit for those with a high risk of heart attack or stroke. In general, people who benefit from statins include those who have:
- Previously had a heart attack, stroke or bypass surgery
- High LDL cholesterol but no current heart disease
The benefit of statins increases over time. As for risks, there are very few concerns in taking statins and side effects, such as muscle aches or weakness, are often managed by adjusting dosages or changing your medication to a different statin according to your health care provider's instructions.
2. Antiplatelet agents, like aspirin and clopidogrel
First used for its cardiovascular benefits in the 1960s, aspirin is an antiplatelet medication, meaning it prevents platelets (a kind of blood cell) from forming clots. This keeps your arteries clear and open to prevent heart attack and stroke.
Daily low-dose aspirin is often recommended as a part of a treatment and prevention plan for people who have had a heart attack or stroke. The standard dosage is 81 mg — or one baby aspirin.
Also an antiplatelet medication, clopidogrel is used on its own or alongside aspirin. Clopidogrel is often prescribed to people with:
- A stent along with aspirin
- Angina (chest pain) that is getting worse
- Acute coronary syndrome (where there's a blockage in the blood flow to the heart)
- Previous heart attack or stroke
- Other circulatory issues, like peripheral arterial disease
Some people use aspirin combined with another antiplatelet medication. This is called dual antiplatelet therapy (DAPT).
There are risks to antiplatelet medications, such as serious bleeding. This is especially true if you drink alcohol. You should not take daily aspirin or any antiplatelet medication without talking to your health care provider first.
"High blood pressure is a major risk factor for heart attack and stroke. Beta-blockers slow your heart rate and how forcefully it contracts, which lowers your blood pressure. It also makes your heart beat slower and less forcefully. This puts less strain on your heart," says Dr. Kramer.
Beta-blockers are used for people who have:
- High blood pressure
- Previous heart attack
- Chest pain (angina)
- Some abnormal heart rhythms
- Congestive heart failure (CHF)
Because beta-blockers slow your heart rate, they can lead to dizziness, which can usually be managed by adjusting your dosage. Other risks include kidney and liver problems.
4. Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin is a hormone that keeps your blood pressure regulated by narrowing your blood vessels and increasing your blood pressure. ACE inhibitors keep your body from making this hormone, by widening blood vessels it lowers blood pressure. This limits how hard your heart has to work and helps to prevent heart attack and stroke.
ACE inhibitors are usually given to people with:
- High blood pressure
- Congestive heart failure (CHF)
- Recent heart attack
Risks are minimal with ACE inhibitors. They include elevated potassium, dry cough, dizziness, headaches and loss of taste. In rare cases, they can lead to temporary worsening of kidney function.
5. Anticoagulants — or blood thinners
Blood thinners, such as warfarin or heparin, don't actually thin your blood, but they do make it harder for your blood to clot. This helps prevent blood clots from forming in your blood vessels and existing clots from becoming worse — both of which reduce your chance of heart attack or stroke.
Anticoagulants are often prescribed to people who have:
The primary risk of taking an anticoagulant is bleeding, which is managed by ensuring you take the correct dosage.
Heart medications: Life-saving tools
Thanks to advancements in medicine, there are many options available to reduce your risk of heart attack and stroke. If you're at risk for or currently have heart disease, one or more of these medications may become a part of your daily routine. Always be sure to follow your health care provider's instructions when taking these medications and keep up with routine visits.
Make an appointment with Howard Kramer, MD
Learn more about heart and vascular care at Main Line Health
Daily aspirin therapy: Do you know the benefits and risks?