Yahoo Lifestyle What You Need to Know About Heart Medication
The drug: aspirin
What it does: Tiny yet mighty, this white pill helps heart-disease sufferers prevent blood clots. Aspirin inhibits the effects of prostaglandins, a powerful group of naturally occurring substances, one of which helps blood platelets clump together.
What you should know: If you have coronary heart disease, you’re probably already taking aspirin, unless you have another condition (such as an active stomach ulcer) that makes it too risky. However, if you don’t have heart disease, don’t be tempted to ‘stay ahead of the game’ by popping a daily pill. In general, the danger of serious internal bleeding (especially in the gastrointestinal system and the brain) outweighs any potential benefits. If you’re unsure of what’s best for you, talk to your GP.
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The drug: clopidogrel hydrogen sulfate (Brand names: Plavix and Iscover)
What it does: A kind of superaspirin, this drug is even more effective at preventing blood clots, particularly when used in combination with aspirin. Australian doctors often prescribe it for acute coronary syndromes.
What you should know: Because clopidogrel is more potent than aspirin, it’s also more likely to cause internal bleeding: about 3% of patients experience problems with moderate or severe bleeding. Also, some people are poor metabolisers of the drug, meaning their livers struggle to convert it into a form that their bodies can use, so they don’t enjoy all of its benefits. A genetic test can determine whether you’re likely to be a poor metaboliser (the risks are higher for Chinese people than for Caucasians), but your doctor could be more inclined to simply prescribe clopidogrel and monitor your response to it over time.
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The drug: warfarin sodium (Brand names: Coumadin and Marevan)
What it does: As an anticoagulant, warfarin can treat and prevent blood clots, too. But this drug is more powerful than both aspirin and clopidogrel, and it also works differently.Warfarin restricts clotting by blocking vitamin K, a nutrient that the liver uses to produce proteins that cause blood to clot.
What you should know: Warfarin interacts with many other medicines, making it a challenge to use safely. Always tell your doctor what drugs you’re taking, as aspirin, laxatives, St John’s wort, cold medicines and even cranberry juice may interfere with warfarin. And the fact that this drug affects vitamin K (which we obtain from leafy green vegetables) means that abrupt changes in your diet can result in too little or too much blood thinning. So there’s a lot to bear in mind. Still, if your doctor has prescribed warfarin, he or she has weighed up the pros and cons and decided that it will help you. (You’ll probably need to have regular blood tests to monitor the drug’s effects.)
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The drugs: beta-blockers (Brand names include Toprol-XL, Betaloc, Tensig, Tenormin, Metrol, Minax and Noten)
What they do: Beta-blockers are cardiac ‘chill pills’—decreasing not only the rate at which the heart beats but also the strength of its contractions. Doctors use these multitasking drugs to treat chest pain (angina), to stabilise uneven heart rhythms and to maintain heart health after a patient has suffered from a heart attack or congestive heart failure, all of which are essential to cardiovascular care.
What you should know: Beta-blockers can have the undesirable side effect of overly lowering your heart rate, causing dizziness or low blood pressure. There’s also a slim chance that they can cross the blood-brain barrier, where they can trigger nightmares and even depression.
If you have asthma or any other chronic lung disease, these drugs aren’t for you, as they constrict the lungs’ airways. Although doctors can prescribe beta-blockers to treat high blood pressure (even when a patient has no other heart condition), they’re starting to consider them passé for this purpose. Other drugs, including ACE inhibitors, amlodipine and diuretics provide more protection.
The drugs: ACE inhibitors (Brand names include Capoten, Renitec, Monopril and Accupril)
What they do: There are eight different types of ACE inhibitors available in Australia, sold under a whopping 81 different brand names!
But they all work in the same way: they stop the body from producing angiotensin, a hormone that causes arteries to constrict—and this makes it easier for the heart to pump blood. Although ACE inhibitors were originally intended to lower blood pressure, cardiologists currently prescribe them to prevent additional heart damage in patients who’ve recently had a heart attack or experienced congestive heart failure. Result? They simultaneously treat and protect.
What you should know: These drugs can prolong your life! According to the Queensland Government booklet Living with Heart Failure, studies have found that when people who had experienced heart failure took ACE inhibitors for one year, they cut their mortality risk by 30%.
When you take them alone, these medications produce a moderate reduction in blood pressure, but taking them with a low dose of a diuretic results in an even more impressive drop. But be aware: although millions of patients are safely using ACE inhibitors, these drugs can occasionally impair kidney function, increase potassium levels in the blood or cause angioedema—a condition characterised by swollen lips that can result in obstructed airways. (These unwelcome side effects usually improve when the patient stops taking the drug.)
It’s also important to ensure you’re not doubling up on your medications, as the sheer number of different brands can be confusing. For information on how to check the active ingredient of a drug, head to nps.org.au/bemedicinewise.
The drugs: statins (Brand names include Lipitor, Lescol, Pravachol, Crestor and Zocor)
What they do: These clever drugs trick the liver into removing more cholesterol from the blood than it would naturally. In fact, statins have been found to lower ‘bad’ LDL cholesterol levels by 20 to 50%—results that are good news for millions worldwide.
What you should know: Some patients and doctors are concerned about a possible link between statins and liver damage, but such a case has never been solely attributable to a statin. (Your doctor usually decides whether you need regular liver-function tests.) In rare instances, these drugs can cause severe muscle damage, so if you’ve started on a statin and are experiencing extreme muscle pain, contact your doctor immediately.
It’s particularly vital to do so if your pain is accompanied by tea-coloured urine. Mild muscle discomfort is more common (and less dangerous). You can usually ease it by changing your dose or switching statins.
