There are a range of drugs doctors can use to treat heart disease. Many people will find that they’re advised to take several different medicines together, depending on the nature of their heart problem and whether they have risk factors such as high blood pressure.
Many heart drugs have minor side-effects, but most settle down in time. Your doctor and/or pharmacist will alert you to any side-effects and what you should do about them, and you’ll also find details in the information leaflet that comes with your medication. If you develop any unexpected effects, or if you’re worried, contact your doctor.
Aspirin and antiplatelets
These prevent blood clotting in the arteries by reducing the stickiness of blood cells called platelets, which are involved in clotting. This helps to improve blood flow in narrowed coronary arteries and reduces the risk of a blocked artery leading to a heart attack. Aspirin can reduce the risk of dying from a heart attack by 25 per cent or more. These drugs are also used after heart bypass surgery to prevent blood clotting.
These are used to prevent angina, treat high blood pressure and improve heart failure. They work by blocking the effects of stress hormones, which make your heart beat faster and more forcefully. By slowing the heart and also relaxing the arteries throughout the circulation, the heart doesn’t have to work so hard, which helps in heart failure. Beta blockers also lower the risk of another heart attack if you have already had one, and/or help control abnormal heart rhythms (arrhythmias).
Calcium channel blockers
There are different types of calcium channel blockers and they have differing effects. Some relax and dilate the blood vessels and are used for treating angina, high blood pressure and heart failure, while others slow the rate at which the heart beats and are used to treat abnormal heart rhythms.
These drugs, often referred to as ‘water tablets’, may be used to control blood pressure or remove excess fluid from the body in heart failure. They act by increasing the excretion of water and sodium by the kidneys.
Nitrates dilate the coronary arteries. This improves blood flow to the heart muscle, which helps to relieve angina. Glyceryl trinitrate (GTN) is a commonly used nitrate. It’s in the tiny pills, or spray, that people put under their tongue during an angina attack. Dilation of the arteries reduces the work the heart has to do to pump blood around the body, so nitrates are helpful in heart failure, too.
These drugs are used to help reduce the amount of cholesterol in the blood. High levels of cholesterol are a risk factor for heart disease. By lowering unhealthy levels of cholesterol, the risk of CHD and heart attacks is reduced.
This group of drugs has radically improved the treatment of, and survival from, heart attacks in the past decade. They dissolve clots that form in a coronary artery and trigger heart attacks.
If the drugs are given quickly enough – within a couple of hours of onset of a heart attack – they’ll restore the blood flow through the artery in time to avoid permanent damage to the heart muscle. The earlier this treatment’s given, the better.
However, because the drug thins the blood it can cause brain haemorrhage (stroke) in a significant number of patients