Main classes of heart medications

  • Medications for the heart belong to several different classes (or families). Each class affects the heart in a different way, and you may need one from each group.
  • It is important to understand how they work, and what the potential side effects are.
  • Medications important for heart patients, specifically those with a history of a heart attack, for those with a history of blocked arteries, and for those who experience chest discomfort when exercising may include: antiplatelets, statins, ACEi/ARB and beta-blockers.
    • Antiplatelet medications: These are medications that prevent platelets in the blood from sticking together. When blood sticks together, blood clots can form. These medications can prevent a future heart attack or stroke.  Examples of antiplatelet medications include acetylsalicylic acid (Aspirin® or ASA), clopidogrel (Plavix®), and ticagrelor (Brilinta®).
    • Statin medications: These are medications that can slow down any plaque in the arteries from getting larger, while also preventing plaque from rupturing or breaking off. Statin medications can also lower blood cholesterol levels. These medications can prevent a future heart attack or stroke. Examples of statins include: atorvastatin (Lipitor®) and Rosuvastatin (Crestor®).
    • ACEi/ARB medications: These are medications that can protect heart function and prevent heart attack and stroke. These medications can be prescribed for high blood pressure management.  It is important to know that even if you don’t have high blood pressure these medications can prevent heart attack and stroke once you have coronary artery disease.  Examples of ACEi/ARB include perindopril (Coversyl®), ramipril (Altace®), telmisartan (Micardis®), and candesartan (Atacand®).
    • Beta-blocker medications: These are medications that can prevent a future heart attack and are often prescribed for patients living with certain irregular heartbeats, heart failure, and/or high blood pressure. Examples of beta-blockers include metoprolol, bisoprolol, carvedilol.

Common side effects

  • Antiplatelet medications: These medications can increase the risk bleeding. Minor and inconvenient bleeding can be referred to as “nuisance bleeds”. Nuisance bleeds include bruising of skin, gum bleeding, and nose bleeds. These bleeds are usually not serious. More serious concerns with antiplatelet medications are stomach issues, such as stomach ulcers and stomach bleeding. When taking antiplatelet medications, it is very important not to take nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Advil®, Motrin®), or Naproxen (Aleve®). NSAIDs when taken with antiplatelet medications can increase the risk of future heart attacks and stomach bleeds.
  • Statin medications: These medications can cause muscle aches; however, it is very important to rule out other causes for muscle aches with your doctor before this medication is reconsidered. When taking statin medications, your family doctor or heart doctor will order regular blood work to check your liver enzyme levels. This test can closely monitor the health of the liver.
  • ACEi/ARB medications: These medications can cause symptoms of low blood pressure, such as dizziness. ACEi medications can cause a cough. In very rare cases, these medications can cause swelling of the tongue or lips, known as angioedema.
  • Beta-blocker medications: These medications can cause low heart rates, both at rest and during exercise, as well as cause symptoms of low blood pressure. A low heart rate or low blood pressure can cause dizziness or feeling weak. It is recommended special care is taken for those who are living with asthma and for those who are diabetic and on insulin.

Understanding heart disease & how medications can help

  • Over time, plaque can build up in the arteries.
  • ACEi/ARB medications, beta-blockers and statins can decrease inflammatory mediators in the blood and prevent plaque from getting larger or become unstable. These medications also help stabilize plaque inside the arteries, preventing plaque from cracking and/or rupturing.
  • If an area of plaque cracks and/or ruptures inside an artery, tiny blood cells known as platelets will rush to the area and create a blood clot. The blood clot resulting from the damaged plaque can cut off blood supply and can cause a heart attack or stroke if left untreated.
  • Antiplatelet medications can prevent the platelets from sticking together, thereby preventing blood clots and future heart attacks or strokes.
  • For those who have had an angioplasty (placement of a stent in the artery), the risk of developing a blood clot inside the stented area is significantly higher. For this reason, antiplatelet medications are very important after an angioplasty to prevent blood clots from forming in the stented area.
  • Taking antiplatelet medications, ACEi/ARB medications, beta-blockers and statins can reduce your long-term risk of having a heart attack, heart failure or stroke.

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