Heart Medications

The following is a list of several classes of drugs, some of which you may be prescribed.

Antihypertensives are taken to lower high blood pressure. Uncontrolled high blood pressure, often referred to as the "silent killer," can lead to stroke, heart attack, heart failure, or kidney failure. There are several kinds of high blood pressure medications; some of them are listed below^{63,64,65,66,67}:

• Diuretics: By working in the kidney to flush excess water and sodium from the body, these drugs decrease the amount of fluid flowing through your blood vessels, resulting in decreased pressure on the walls of your arteries.
• Beta-blockers: By reducing nerve impulses to the heart and blood vessels, beta blockers slow the heart rate with less force; blood pressure drops and the heart works less hard.
• Alpha-2 Receptor Angonist: This class of drugs reduces blood pressure by inhibiting these nerves from constricting (narrowing) blood vessels.
• Vasodilators: These drugs can cause the muscle in the walls of the blood vessels to relax, allowing the vessel to dilate (widen) and improving blood flow.
• Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors help to relax blood vessels by interfering with the body's production of angiotensin II, a chemical that causes the arteries to constrict.
• Angiotensin II receptor blockers: These drugs block the effects of angiotensin I, a chemical that narrows the blood vessels by causing them to contract.
• Calcium antagonists (calcium channel blockers): These drugs prevent calcium from entering the muscles in the heart and blood vessels, thereby relaxing the blood vessels and reducing heart rate.
• Combination products: Depending on your blood pressure, the combination of two medications (i.e., a diuretic and a beta-blocker) can lower your blood pressure more quickly and may reduce the risk of developing complications associated with high blood pressure. Multiple medications, such as two diuretics, can also be combined into one pill.

Cholesterol-Lowering Medications

Cholesterol-lowering medications help reduce levels of unwanted blood cholesterol and may be helpful if given soon after a heart event to improve the chances of survival. Examples of cholesterol-lowering medications include^68,69,70,71:

• Statins: This class of drugs work in the liver to prevent the formation of cholesterol and improve the liver's ability to remove the LDL (bad) cholesterol already in the blood. Statins are most effective at lowering the LDL (bad) cholesterol, but also have a modest effect on lowering triglycerides (blood fats) and raising HDL (good) cholesterol.
• Niacin: This drug works in the liver by affecting the production of blood fats. Niacin is prescribed to lower triglycerides and LDL cholesterol and raise HDL cholesterol.
• Fibrates: Fibrates are best at lowering triglycerides and, in some cases, increasing HDL levels. These drugs are not very effective in lowering LDL cholesterol.
• Resins: This class of LDL-lowering drugs work in the intestines by promoting increased removal of cholesterol from the blood.
• Bile acid sequestrants: These medications bind with cholesterol-containing bile acids in the intestines and are then eliminated in the stool. Bile acid sequestrants aim to lower LDL cholesterol and are sometimes prescribed with a statin for patients with heart disease to increase cholesterol reduction.

Oral Antiplatelet Therapy

Oral antiplatelet therapy helps prevent platelets (particles circulating in the blood that are necessary to form blood clots to maintain hemostasis) from forming blood clots inside the arteries that can lead to heart attack and stroke.⁷²

Oral antiplatelet therapy is beneficial for patients who have had a heart attack or other heart-related conditions caused by clot formation. Studies have shown that oral antiplatelet medications can help lower the risk of cardiac events caused by clot formation.⁶⁰

Depending on the kind of heart event, doctors may use more than one antiplatelet agent to help reduce the risk of clot formation. Typically, this includes the use of aspirin and a thienopyridine (a type of oral antiplatelet agent that is available by prescription only).⁷³ While both these drugs help reduce clot formation, they work on different parts of the platelets.⁷²

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