Understanding Your Medicines
Patients with Coronary artery disease (blockage in the heart arteries) are on a wide variety of medications and this can often be confusing as well as overwhelming. Understanding the rationale for the use of the medications can improve your compliance as well as give you a deeper understanding of the disease process. Below is a list of the most important medications that we use in our practice as well as why we use them:
1. Antiplatelet Drugs- These agents are the cornerstone of therapy in the prevention of heart attacks. They thin the blood by blocking the action of platelets (cells in the blood stream which lead to blood clots). Examples include aspirin, clopidgrel, (Plavix), prasugrel, and (Effient).
2. Beta-Blockers- These drugs are not only useful in lowering the blood pressure to goal (c 140/90), but have been shown in large studies to decrease the risk of heart attack. Examples include atenolol, metoprolol, bisoprolol (Zebeta), and carvedilol (Coreg).
3. ACE Inhibitors/ARBS- These medications are useful in lowering the blood pressure as well as stabilizing the lining of arteries. This in turn slows the progression of blockage and reduces the risk of heart attack. Examples of ACE include ramipril, enalapril, and lisinopril. Examples of ARB’s include
Valsartam, (Diovan), Losartan, (Cozaar), Telmisartan (Micardis).
4. Cholesterol Lowering Drugs- These agents serve to get your lipids to goal (LDL or bad cholesterol <100; in some cases <70)) which in turn slows the progression of blockage and reduces the risk of heart attack. Examples include pravastatin, simvastatin (Zocor), atorvastatin (Lipitor) and vosavastatin (Crestor).
5. Miscellaneous therapies- which may be beneficial include fish oil, Vitamin D in patients with low levels, aggressive therapy for diabetes, 40 minutes of exercise 4 times a week, as well as a glass of wine 4-5 times weekly.