Heart Medications
There are a range of heart conditions affecting the normal function of the heart such as coronary artery disease, blood vessel diseases and heart rhythm problems (arrhythmias). The cardiovascular disease could result in a heart attack, chest pain or stroke. So it is important to seek medical care if suspected of experiencing heart disease symptoms such as chest pain, fainting and shortness of breath. However, the good news is that several of the heart problems can be prevented and treated by following a healthy lifestyle. And, various forms of heart medications are used to treat different heart conditions and to lower the risk of developing future heart events. However, all medicines have side effects and if they are bothersome or are causing discomfort, it is important to discuss this with the health care provider as they can help with the management of the symptoms. But it is also essential not to skip any of the medicines as suddenly stopping them can become dangerous.
Common Heart Problems and Medications
Taking medications for the heart can reduce the risk of developing complications later in life such as a stroke, angina or heart attack. Medications can also help with the management of high blood pressure, high cholesterol and thereby enabling a better quality of life. However, it is important to continue the medications even if symptoms are relieved as most of them need to be taken for a long term. Some of the medications used for the treatment of various heart problems include;
Aspirin: It can prevent the blood clot from developing in the narrow artery and therefore reducing the risk of heart attack in the future.
Antiarrhythmic medicines: This helps slow irregular heart rhythms such as supraventricular tachycardia, atrial fibrillation and ventricular tachycardia. Medications in this category include beta blockers, calcium channel blockers, digoxin, amiodarone, flecainide and propafenone. However, some of these may require regular blood tests to check liver, renal and thyroid function.
Antiplatelet Agents: This includes clopidogrel, prasugrel and ticagrelor also used to prevent the blood clots from developing. These are generally administered if the individual had experienced angina, recurring heart attacks, coronary angioplasty and stent implantation.
Anticoagulant Medicines: Warfarin treats both the existing clots and prevents them from forming. With warfarin, regular blood tests are required to determine they are functioning properly. Novel anticoagulant therapies, also known as NOACs, include apixaban, dabigatran and rivaroxaban but don’t require blood testing.
Anti-Anginal Medicines: Nitrate medicines increase the blood flow to the heart by expanding the blood vessels and can be used to both prevent and treat angina. The short-acting nitrate medicines relieve the angina symptoms within a few minutes and the long-acting nitrate medicines prevent angina symptoms. The nitrate medicines can come as a spray, in a tablet form or can also come as patches absorbed through the skin.
Medications for Cholesterol: Statins are used to reduce the risk of heart attack and to lower cholesterol. It is generally administered for those after a heart problem such as an attack or stroke and recommended for everyone with coronary heart disease. Medication doses and the type of statins may be changed to ensure it is working effectively.
Blood Pressure Medications: Angiotensin converting enzyme (ACE) inhibitors help dilate the blood vessels and are used to reduce the blood pressure and help after a heart attack. Angiotensin II receptor blockers (ARB) are used instead of ACE inhibitors in case side effects are evident and also work by reducing strain on the heart. Beta-blockers may also be used for conditions such as angina and arrhythmias. It works by lowering the heartbeat and reducing the blood pressure.
Latest Trends in the Treatment of Heart Disease
In the last few years, several new drugs were approved by the U.S. Food and Drug Administration (FDA) for the treatment of heart conditions. Also, in the year 2017, the advancement in the treatment of cardiovascular conditions will continue to have a great impact in the future.
- Genetic studies have detected gain of function (GOF) PCSK9 mutations as the reason for familial hypercholesterolemia (FH). Individuals with PCSK9 loss of function mutations have lifelong low LDL cholesterol (LDL-C) levels and reduced atherosclerotic cardiovascular disease (ASCVD) risk. This identification has resulted in the development of PCSK9 inhibition in cardiovascular medicine to lower LDL-C. FDA has approved the use of both alirocumab and evolocumab for the treatment of individuals with clinical ASCVD who further require lowering of LDL-C.
- It has been just seven years since the FDA approved the first Direct oral anticoagulants(DOACs) and since then there been other DOACs such as apixaban, edoxaban and rivaroxaban that are preferred for individuals with atrial fibrillation. So, Geoffrey Barnes, MD, FACC of the University Michigan, predicts increased use of DOACs among patients such as those with cancer-associated venous thromboembolism and also among individuals with atherosclerotic disease. He also says these studies are helping us understand the role of very low-dose DOACs in the prevention of thrombotic adverse events among patients with coronary artery disease. Also, 2019 should see the results of the trial AUGUSTUS that is exploring the effects of apixaban vs. warfarin with or without aspirin on individuals with Atrial Fibrillation.
- According to the experts, the results of the COAPT trial in 2018 should present significant implications for valvular heart disease. The study shows that the treatment with MitraClip combined with guideline-directed medical therapy (GDMT) effectively reduced mitral regurgitation (MR).
- The importance of inflammation in atherosclerosis has been a topic of research for several decades. The CANTOS trial investigated the use of canakinumab on high-risk patients with an established atherosclerotic disease who had already survived a myocardial infarction (MI). The results provide an exciting glimpse at the potential for using anti-inflammatory treatment for cardiovascular disease.
- In a recent cardiovascular outcomes trial, Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG Outcome), the sodium-glucose cotransporter 2 inhibitors empagliflozin has shown to reduce cardiovascular mortality and heart-failure among the high-risk patients. The findings also suggest that the results of EMPA-REG OUTCOME could be applied to individuals with Type 2 Diabetes with a boarder cardiovascular risk profile.
References
https://www.ahajournals.org/doi/pdf/10.1161/ATVBAHA.117.310097
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954590/
https://www.heartfoundation.org.nz/your-heart/heart-treatments/medications