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Medication, Lifestyle Changes, and More

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Medication, Lifestyle Changes, and More

Anticoagulants

Anticoagulants are blood-thinning medications that help prevent harmful blood clots from forming or growing. Doctors often prescribe these medications to prevent a person’s first stroke, repeated strokes after a first stroke, or a heart attack.

Medications in this class include:

  • apixaban (Eliquis)
  • dabigatran (Pradaxa)
  • edoxaban (Savaysa)
  • heparin (various)
  • rivaroxaban (Xarelto)
  • warfarin (Coumadin)

Angiotensin-Converting Enzyme Inhibitors

ACE inhibitors expand blood vessels by lowering levels of hormones that regulate blood pressure, reducing how hard the heart has to work to pump blood. This allows blood to flow through the body more efficiently, helping to treat high blood pressure and supporting health after a heart attack.

Medications in this class include:

  • benazepril (Lotensin)
  • enalapril (Vasotec)
  • fosinopril (Monopril)
  • lisinopril (Prinivil, Zestril)
  • quinapril (Accupril)
  • ramipril (Altace)

Angiotensin II Receptor Blockers

Angiotensin II receptor blockers help manage blood pressure by blocking a hormone that constricts blood vessels, allowing the vessels to relax. Doctors might prescribe ARBs to people with heart failure and high blood pressure.

Medications in this class include:

  • azilsartan (Edarbi)
  • candesartan (Atacand)
  • irbesartan (Avapro)
  • losartan (Cozaar)
  • olmesartan (Benicar)
  • telmisartan (Micardis)
  • valsartan (Diovan)
Sometimes doctors prescribe sacubitril/valsartan (Entresto), a combination of ARBs and neprilysin inhibitors known as an angiotensin receptor-neprilysin inhibitor. This heart failure treatment improves how the arteries open, reduces how much sodium the body retains, and limits stress on the heart.

Antiplatelet Agents

Antiplatelet agents prevent the formation of blood clots by stopping platelets in the blood from clumping together. Doctors prescribe them after heart attacks, strokes, transient ischemic attacks (TIAs, or mini-strokes), and other types of cardiovascular diseases. If plaque has built up on a person’s coronary artery but isn’t yet causing a severe blockage, a person can also take antiplatelet agents to prevent a blood clot.

Medications in this class include:

  • aspirin
  • clopidogrel (Plavix)
  • dipyridamole (Persantine)
  • prasugrel (Effient)
  • ticagrelor (Brilinta)
Nearly every person with coronary artery disease will need to take aspirin for the rest of their life.

People who have undergone surgery like stent placement or coronary bypass graft surgery, or those who have had a heart attack, may benefit from taking another antiplatelet medication known as a P2Y12 inhibitor at the same time. This combination is known as dual antiplatelet therapy.

Beta-Blockers

Beta-blockers work by slowing the heart rate, helping it beat less forcefully, and decreasing the effects of the hormone adrenaline on the heart. They also help lower blood pressure, so the heart doesn’t have to work as hard. Doctors prescribe beta-blockers to prevent future heart attacks in people with a history of them, as well as to treat high blood pressure, chest pain (angina), and issues with heart rhythm.

Medications in this class include:

  • acebutolol
  • atenolol (Tenormin)
  • bisoprolol
  • metoprolol (Lopressor, Toprol XL)
  • nadolol (Corgard)
  • nebivolol (Bystolic)
  • propranolol (Inderal LA, InnoPran XL)

Calcium Channel Blockers

Calcium channel blockers disrupt how calcium moves into blood vessel cells and heart cells, relaxing the blood vessels and lowering the heart rate. A healthcare professional may prescribe calcium channel blockers to treat angina, arrhythmias, or high blood pressure.

Medications in this class include:

  • amlodipine (Norvasc)
  • diltiazem (Cardizem, Tiazac)
  • felodipine (Plendil)
  • nifedipine (Adalat, Procardia)
  • nimodipine (Nimotop)
  • nisoldipine (Sular)
  • verapamil (Calan, Verelan)

Cholesterol-Lowering Medications

Cholesterol-lowering medicines, such as statins, decrease levels of low-density lipoprotein (LDL, or “bad”) cholesterol in the blood, which can help reduce the risk of severe heart problems. Statins are the most common medication doctors prescribe in this class. Other options are often only prescribed when statins cause severe side effects or don’t work as intended.

  • atorvastatin (Lipitor)
  • fluvastatin (Lescol)
  • lovastatin (Mevacor)
  • pitavastatin (Livalo)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)
Other medication classes that reduce cholesterol include nicotinic acids like niacin or cholesterol absorption inhibitors, such as ezetimibe (Zetia). Some medications like ezetimibe/simvastatin (Vytorin) combine statins with cholesterol absorption inhibitors.

Digitalis

Digitalis can help the heart contract harder when its pumping function has been weakened and can slow a rapid heartbeat. This medication can help people manage arrhythmias like atrial fibrillation or heart failure symptoms when they don’t get good results from ACE inhibitors, ARBs, or diuretics.

Digoxin (Lanoxin) is the main digitalis medication doctors prescribe for heart disease.

Diuretics

Diuretics, or “water pills,” eliminate excess fluids and sodium through urination, helping relieve the heart’s workload and reduce blood pressure. These pills also decrease fluid backup in the lungs and other parts of the body, such as the ankles and legs, due to heart failure.

“Thiazide diuretics are among the oldest heart disease medications,” says Majure. “They’ve been around since the 1960s, and we use them to this day.” Other diuretics include loop diuretics and potassium-sparing diuretics.

Medications in these classes include:

  • amiloride (Midamor)
  • bumetanide (Bumex)
  • chlorthalidone (Hygroton)
  • furosemide (Lasix)
  • hydrochlorothiazide (Esidrix, Hydrodiuril)
  • triamterene (Dyrenium)
  • triamterene and hydrochlorothiazide combined

GLP-1 Agonists

GLP-1 agonists like semaglutide mimic a hormone that the small intestine produces that leads to insulin release, blocks glucose-releasing hormones, helps the stomach empty more slowly, and increases a person’s feelings of fullness after eating. These drugs were developed to treat type 2 diabetes and are also prescribed to treat obesity. They can have a broad range of positive effects on heart disease risk factors.

In 2024, the U.S. Food and Drug Administration approved Wegovy, a drug containing semaglutide, to reduce the risk of stroke, heart attack, and heart disease–related death in people who are overweight or have obesity.

Vasodilators

Vasodilators expand blood vessels to improve blood flow to the heart, decreasing the effort of pumping and controlling blood pressure. Nitrates, one type of vasodilator, improve blood and oxygen supply to the heart, which can help reduce angina. Pregnant women can also take this medication to reduce high blood pressure.

Medications in this class include:

  • isosorbide dinitrate (Isordil)
  • isosorbide mononitrate (Imdur)
  • hydralazine (Apresoline)
  • nitroglycerin (Nitro-Bid, Nitro Stat)
  • minoxidil

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