Medicines for Coronary Artery Disease
In recent years, better medicines have made it easier to take care of coronary artery disease. Medicines such as beta-blockers, ACE inhibitors, and statins, have helped many people stay healthy and avoid heart attacks.
Aspirin is the most common medicine prescribed by doctors for people with coronary artery disease. Aspirin helps prevent heart attacks in people with coronary artery disease. 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 decreases blood flow the heart and causes heart attacks. There are typically 2 doses of aspirin: 81 mg (baby aspirin) and 324 mg. If you are over age 50, ask your doctor if you should be taking daily baby aspirin. It's important to take this medicine daily as directed by your doctor.
Beta-blockers are among the most commonly used drugs for controlling high blood pressure and improving blood flow to the heart. They slow the heart rate, lower blood pressure, and decrease the amount of work the heart must do. When the heart works more efficiently, it needs less oxygen from your blood. By lowering the heart's oxygen needs, beta-blockers may help prevent or relieve poor blood flow, which is an important factor in heart attacks.
Beta-blockers can cause side effects such as decreased sexual ability and fatigue in some people. People with asthma, heart failure, or diabetes should be cautious about taking them because they can worsen these conditions. Certain, selective beta-blockers, however, are less likely to cause these side effects. Tell your doctor if you have a history of asthma or any kind of lung disease before starting this medicine.
Angiotensin-converting enzyme (ACE) inhibitors are used to lower blood pressure and make it easier for the heart to pump blood. These drugs work by blocking a hormone called angiotensin II, which makes the blood pressure higher, among other effects. ACE inhibitors can be particularly useful if the heart muscle has suffered damage from coronary heart disease. This medicine helps remodel the heart in heart failure.
The most common side effect of taking an ACE inhibitor 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 develop side effects from this medicine, tell your doctor right away.
Statins are the most frequently prescribed type of cholesterol-lowering drugs. They block a key liver enzyme involved in making cholesterol. This helps reduce the amount of cholesterol that can be deposited into the blood. This allows more LDL, or "bad," cholesterol to be removed from the blood. Dietary changes are also important to help lower cholesterol, however, statins have other beneficial effects in addition to lowering cholesterol. 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-related condition.
Statins have few known side effects, but in rare cases they can damage the liver and muscles, so it is important to take only recommended doses. Statins can also make people drowsy, constipated, or nauseous, although these side effects are uncommon. One plus is that these drugs do not appear to interfere with the other medicines that people with heart disease often take. And they require only a single daily dose. Statins are one of the most effective medicines to prevent and treat heart disease.
Talk with your healthcare provider if you have questions about any of these medicines.
March 21, 2017
Pflieger, M., Medical Management of Stable Coronary Artery Disease, American Family Physician (2011); 83(7);819-826, Staywell CAD/Fall 2006, Sweitzer, NK. Cardiology Patient Page: What is an Angiotensin Converting Enzyme Inhibitor? Circulation (2003); 108(3); pp. e16-e18
Fetterman, Anne, RN, BSN,Gandelman, Glenn, MD, MPH