The development of these medications have helped dramatically decrease death rates from cardiovascular disease in the United States and other developed countries.
Heart Medications Articles
The benefit of taking a daily aspirin to protect against a heart attack is well established, but this protection comes with some increased risk of gastrointestinal bleeding. Here are some questions and answers to help you decide if taking a daily aspirin is right for you.
I avoid grapefruit juice because my doctor says it affects how my body handles the Lipitor I take for my cholesterol. Should I also stay away from pomelo?
Although lifestyle changes are an essential first step in treating coronary artery disease, you may need to take medications to reach your cholesterol and blood pressure goals and otherwise reduce your risk. In fact, most people with heart disease need to take more than one medication. The specific combination of drugs will depend on your particular symptoms and risk factors. Some of the most commonly prescribed medications are described below.
For many years, doctors used diuretics — sometimes known as water pills — to treat high blood pressure. Although diuretics remain a mainstay of blood pressure treatment because they are cheap and effective, a flood of other drugs have become available since the 1980s. In addition, a large meta-analysis comparing the various options concluded that the five categories of drugs currently available are equally effective for most people. Work with your doctor to determine the best type of medication for you.
It is important to keep in mind, though, that most people with hypertension do not get their blood pressure under control with the starting dose of the first drug chosen. At that point, two philosophies exist about what to try next. Some doctors increase the dosage of the first drug to see if it will bring blood pressure down to target levels. The advantage of this approach is simplicity, as the person being treated takes one pill per day. A second approach is to use low doses of two or more blood pressure drugs that work in different ways. This approach minimizes the likelihood of side effects, but may be harder to follow, as it requires taking two or more pills per day. It may also be more expensive for the person being treated, as he or she may face additional copayments or out-of-pocket expenses for the drugs. A compromise approach is to use combination medicines that include, for example, both an ACE inhibitor and a low-dose diuretic. This is convenient, but many combinations are available only in brand-name forms and are thus more expensive.
What's the best way to "fix" a narrowed coronary artery? That question was the crux of a multimillion-dollar trial dubbed COURAGE, short for Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation. Its results, presented in the spring of 2007, stunned some doctors and seemed to shock the media, but we hope they won't come as a surprise to readers: For people with stable coronary artery disease (clogged arteries nourishing the heart), artery-opening angioplasty was no better than medications and lifestyle changes at preventing future heart attacks or strokes, nor did it extend life.
The media tended to play up the COURAGE results, which were presented at the American College of Cardiology's annual meeting in March, as a David slays Goliath story. But it wasn't that at all.
Before going any further, it's important to stress that this trial compared angioplasty and medical therapy only for stable angina (chest pain on exertion) or narrowed coronary arteries that don't cause any symptoms. For a sudden blockage of a coronary artery, emergency artery-opening balloon angioplasty followed by the placement of a stent is the best remedy around.