Medicines for Coronary Artery Disease (CAD)

Medicines have made it easier to take care of coronary artery disease (CAD). The medicines help many people stay healthy and prevent heart attacks. They include beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and statins. Learn more about these and other medicines below.

Aspirin

Aspirin is the most common medicine prescribed by healthcare providers for people who have had a heart attack or stroke. Aspirin helps prevent future heart attacks or strokes. Taking aspirin once a day helps make platelets less sticky. When platelets stick together to form a plug, they cause blockages in the arteries. This lessens blood flow to the heart. This causes heart attacks. There are two doses of aspirin: 81 mg (baby aspirin) and 324 mg (adult). Take this medicine as directed by your healthcare provider.

Beta-blockers

Beta-blockers are a common type of medicine for controlling high blood pressure. They slow the heart rate, lower blood pressure, and lessen the amount of work the heart needs to do. When the heart works better, it needs less oxygen from your blood. By lowering the heart's oxygen needs, beta-blockers may help prevent or relieve poor blood flow. This is an important factor in heart attacks.

Beta-blockers can cause side effects. These can include fatigue and sexual problems in some people. People with asthma or diabetes should be careful about taking them. This is because they can make these conditions worse. Some beta-blockers are less likely to cause these side effects. Tell your healthcare provider if you have a history of asthma or any kind of lung disease before starting this medicine.

Calcium channel blockers

Calcium channel blockers may be used if beta-blockers give you bad side effects or don't prevent chest pain (angina). These medicines relax the pumping chamber of the heart. They also relax the arteries. This causes better blood flow. Calcium channel blockers should not be taken if you have a low pumping function of the heart (reduced ejection fraction). This can cause heart failure. Side effects include fluid buildup, swelling (edema), and low blood pressure.

ACE inhibitors

ACE inhibitors are used to lower blood pressure. They make it easier for the heart to pump blood. These medicines work by reducing the levels of a hormone called angiotensin II. This hormone can increase blood pressure and make the heart work harder. ACE inhibitors can be useful if the heart muscle has damage. This medicine helps change the way your hearts works if you have heart failure.

The most common side effect is a dry, hacking cough. Changing the dose or changing to a different medicine often helps the cough go away. Other side effects include low blood pressure and kidney problems. If you have side effects from this medicine, tell your healthcare provider right away.

Angiotensin receptor blockers (ARBs)

ARBs are also used to reduce the workload on the heart. This type of medicine is related to ACE inhibitors. They are used when ACE inhibitors cause a cough, or other side effects. Blocking the receptor for angiotensin II prevents the blood vessels from narrowing and causing the blood pressure to rise. Keeping the blood pressure from rising reduces the work of the heart muscle. This prevents angina or a heart attack. This type of medicine is also useful in people who have a damaged heart muscle from a heart attack. It can help prevent heart failure.

Statins

Statins are the most common type of medicines to lower cholesterol. They block a liver enzyme that makes cholesterol. This helps reduce the amount of cholesterol that can be sent into the blood. This allows more LDL "bad" cholesterol to be removed from the blood. Statins have other benefits, too. Studies have shown that people who use statins, even if their cholesterol level is fine, have a reduced risk for heart attack, stroke, chest pain, and death from a heart condition.

Statins have a few side effects. In rare cases, they can damage the liver and muscles. It's important to take only recommended doses. Statins can also make people drowsy, constipated, or nauseated. These side effects are not common. They are taken as a single daily dose. Statins are one of the most effective medicines to prevent and treat heart disease.

Nitrates

Nitrates or nitroglycerin is used to prevent or treat chest pain caused by CAD. When you exercise, this can increase the workload on the heart muscle. Narrowed or blocked arteries prevent the heart muscle from getting the oxygen and blood that it needs during exercise. Nitrates relax the coronary arteries. They also relax other arteries and veins. This improves blood flow. It reduces the workload on the heart. These medicines can be taken as a pill, an under-the-tongue tablet, or spray. Or they may be absorbed through a patch on the skin. Some of the side effects include a headache, dizziness, light-headedness, flushing, or a drop in blood pressure. You should not take nitrates if any of these apply to you:

• You have had a heart attack that affects the right pumping chamber (ventricle)

• You have a thickened left ventricle with blocked blood flow to the body (hypertrophic cardiomyopathy)

• You use medicines for erectile dysfunction

Talk with your healthcare provider if you have questions about any of these medicines.