Heart Medications Archive

Use simple tools to manage heart pills

Science has developed a wide array of medications that reduce the symptoms of heart disease and prevent catastrophic events such as stroke or heart attack. But people with heart disease often are overwhelmed with the task of keeping up with—and taking—all these wonder drugs.

Heart disease is the leading cause of death for people with diabetes. Diabetes drugs lower blood sugar, but that benefit must be weighed against possible harm to the heart—an evaluation now required by the FDA. Dr. Deepak L. Bhatt, editor in chief of the Harvard Heart Letter and professor of medicine at Harvard Medical School, co-led the most comprehensive study ever done of a diabetes drug's heart effects.

The drug, saxagliptin (Onglyza), was approved in 2009 for people with diabetes after clinical trials showed it improved blood sugar control. Data from those trials also suggested that it reduced heart disease. But the new two-year study, reported by Dr. Bhatt's team in The New England Journal of Medicine, found Onglyza did not reduce heart risk compared with placebo in 16,492 people with diabetes and at high risk of heart disease. Importantly, however, the drug did not increase the risk of cardiovascular disease or stroke.

Don't sabotage your health by not taking your medications.

Taking calcium-channel blockers long-term to control high blood pressure may increase the risk of breast cancer. Other types of blood pressure drugs don't seem to have the same effect.

Q. I take the beta blocker propranolol twice a day, once in the morning and again in the evening. The drug information label says I should not take propranolol with alcohol. But I like to have two glasses of wine in the evening. Do I need to change medications, or is there a way to handle the wine and propranolol together?

Q. There is a long list of drugs and substances that interact with Coumadin (warfarin). Does this mean they make Coumadin more effective, or less effective?

A. This is an important and useful question. Some medications can strengthen warfarin's anti-clotting effect, while others can weaken it. There are really two ways in which other drugs influence the effectiveness of warfarin.

New drugs may be best when starting treatment for atrial fibrillation, but don't switch if warfarin works for you.

A minor stroke or transient ischemic attack (mini-stroke or TIA) is a frightening event. It's often followed within a few days or weeks by a more serious stroke. Rapid treatment of a minor stroke or TIA with aspirin and clopidogrel (Plavix) can help prevent a repeat stroke.

The finding comes from a Chinese study published in the New England Journal of Medicine. The study enrolled more than 5,000 people with underlying stroke risk factors, relatively minor strokes, or major TIAs (but not people with quickly passing dizziness or brief visual or sensory events).

Q. I've been taking Coumadin for some time and have begun taking Plavix after having had several stents put in to open blocked arteries. My doctor said Plavix would prevent clots. Isn't that what Coumadin does?

Q. I am a 78-year-old woman and have atrial fibrillation. My physician prescribed me Coumadin. Last month aspirin was added to my regimen. Is it okay to take both of these drugs together?

A. It is quite common to take aspirin and warfarin together. These two medications prevent blood clots in different ways. Aspirin attacks the platelets, the tiny cells that start blood clots. Warfarin decreases the amount of clotting proteins that that the liver makes. In addition to treating your atrial fibrillation with warfarin (Coumadin), your doctor probably decided you need aspirin for another reason. Although using two different methods to prevent blood clots does increase the risk of bleeding, it is generally accepted as safe given the potential benefits.