There is a wide range of medications that are currently used to treat cardiac disease. Some of these medications are described below.
- Blood thinners or anticoagulants – Examples of anticoagulants include heparin, enoxaparin, dalteparin, tinzaparin and warfarin. These agents decrease the clotting ability of the blood and prevent blockages in the blood vessels that may lead to heart attacks and strokes. Anticoagulants cannot dissolve a clot that is already formed, but they prevent the expansion of any existing clots and stop the formation of any new clots.
- Antiplatelet agents – Examples of antiplatelet agents include aspirin, ticlopidine, clopidogrel and dipyridamole. These drugs prevent platelets from sticking together and forming blood clots. They are useful for preventing recurrent attacks in patients who have already had a heart attack. They are also used to prevent recurrence in unstable angina, ischemic stroke and TIA (transient ischemic attacks).
- Angiotensin-converting enzyme (ACE) inhibitors – Examples of these agents include captopril, enalapril, lisinopril, perindopril and ramipril. ACE inhibitors decrease the production of a hormone called angiotensin II. This relaxes the blood vessels and reduces re-absorption of water in the kidneys, which, in turn, decreases blood pressure.
- Angiotensin II receptor blockers – Examples of these drugs include candesartan, irbesartan, losartan, telmisartan and valsartan. These agents also prevent the actions of angiotensin II, but by blocking the angiotensin II receptor rather than lowering the level of angiotensin II in the blood.
- Beta-blockers – Examples of these drugs include atenolol, acebutolol, bisoprolol, metoprolol, nadolol and sotalol. These agents act by reducing the heart rate, cardiac output and blood pressure. They are used to treat high blood pressure, cardiac arrhythmias (abnormal heart rhythms), angina, and heart failure. These drugs are used to prevent recurrence of heart attacks in patients who have already had an attack.
- Calcium channel blockers – Examples of these agents include amlodipine, nifedipine, felodipine, nimodipine, diltiazem and verapamil. These drugs prevent the movement of calcium into cells of the blood vessels and heart and are used to treat high blood pressure, angina and arrhythmias.
- Diuretics or water pills – Examples include chlorothiazide, hydrocholorthiazide, cholrthalidone, furosemide, indapamide, amiloride and spironolactone. These agents increase the amount of salt and water excreted in the urine, thereby lowering the overall blood volume. This means the heart has less work to do and blood pressure is also reduced. Diuretics are used to treat heart failure and hypertension.
- Vasodilators – Examples include glyceryl trinitrate, isosorbide and mononitrate. Vasodilators relax the blood vessels and are used to treat hypertension and angina.
- Digitalis – This cardio-active drug is a steroid that activates the cardiac muscle and is used to treat heart failure, arrhythmia and atrial fibrillation.
- Statins, fibrates and niacin – These drugs help reduce the blood cholesterol level, thereby reducing the risk of heart disease. Examples include atorvastatin, simvastatin, paravastatin, clofibrate, gemfibrosil and niacin.
Reviewed by Sally Robertson, BSc