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Lifestyle modifications, such as diet, exercise, stress management and smoking cessation can significantly improve your heart health. But when lifestyle changes alone are not effective, it may be necessary to add medications. All of these medications can cause side effects, and should only be taken when prescribed by your doctor. A discussion of particular side effects is beyond the scope of this website.

Blood pressure lowering drugs can help control blood pressure. There are different types of high blood pressure medications:

1. Angiotensin-converting enzyme (ACE) inhibitors. These drugs expand blood vessels and decrease resistance. This allows blood to flow more easily and makes the heart’s work easier or more efficient. Frequently prescribed ACE inhibitors include captopril (Capoten), lisinopril (Prinivil, Zestril) and ramipril (Altace).

2. Angiotensin II receptor blockers. Angiotensin-2 (AT-2) receptor antagonists produce effects similar to those produced by ACE inhibitors. They may be better tolerated because they produce less cough. Frequently prescribed angiotensin II receptor blockers include losartan (Cozaar), olmesartan (Benicar) and valsartan (Diovan).

3. Beta blockers. These drugs block the effects of adrenaline on the heart make the heart beat slower and with less force. Frequently prescribed beta blockers include metoprolol (Lopressor, Toprol XL), nadolol (Corgard) and atenolol (Tenormin).

4. Calcium channel blockers. Calcium channel blockers, interrupt the movement of calcium into heart and vessel cells. Frequently prescribed calcium channel blockers include amlodipine (Norvasc), diltiazem (Cardizem), nifedipine (Adalat, Procardia) and verapamil.

5. Diuretics. Diuretics are sometimes called “water pills” because they work in the kidney and flush excess water and sodium from the body. Frequently prescribed diuretics are furosemide (Lasix), spironolactone (Aldactone), hydrochlorothiazide (Esidrix, Hydrodiuril).

Cholesterol medications may help reduce LDL or “bad” cholesterol, decrease tryglecirdes and increase HDL or “good” cholesterol.

1. Statins decrease LDL and triglycerides, slightly increase HDL. Frequently prescribed statins are lovastatin (Mevacor), simvastatin (Zocor), atorvastatin (Lipitor), rosuvastatin (Crestor) and pravastatin (Pravachol) .

2. Cholesterol absorption inhibitors decrease LDL, slightly decrease triglycerides, and slightly increase HDL. Ezetimibe (Zetia) is the most frequently prescribed drug in this group.

3. Combination cholesterol absorption inhibitor and statin decreases LDL and triglycerides, increases HDL. Ezetimibe/simvastatin (Vytorin) is the most frequently prescribed drug in this group.

4. Niacin (vitamin B-3, nicotinic acid) increases HDL substantially and decreases LDL and triglycerides,. The commonly prescribed drugs are prescription niacin (Niaspan) and nonprescription niacin (Slo-Niacin ).

5. Combination statin and niacin decreases LDL and triglycerides, increases HDL. The niacin/lovastatin (Advicor) is the most frequently prescribed drug in this group.

6. Bile acid binding resins decrease LDL. Frequently prescribed medications are colestipol (Colestid), cholestyramine(Questran) and colesevelam (Welchol).

7. Fibrates decrease triglycerides and increase HDL. Frequently prescribed medications are gemfibrozil(Lopid) and fenofibrate (TriCor).

Anticoagulants (blood-thinners)
Many people with various forms of heart disease (e.g. atrial fibrillation, artificial heart valves, pulmonary emboli, stents) need to take blood-thinners to prevent blood clots forming in the heart or blood vessels. Anticoagulants are usually given by mouth, but can also be given by vein (intravenous) or by injecting right under the skin.

1. Anticoagulants given by mouth (orally) decrease the clotting tendency by interfering with platelets or blocking the body’s production of clotting substances. The most frequently prescribed oral blood–thinners are: aspirin, clopidorel (Plavix), warfarin (Coumadin) and Pradaxa (dabigatran etexilate).

2. Anticoagulant given by vein (intravenously) acts rapidly to thin the blood. The effect also wears off rapidly. Heparin is the intravenous anticoagulant that is often used for a short period of time when oral anticoagulants need to be stopped.

3. Anticoagulants given by injecting under the skin (subcutaneously) are heparin and low-molecular-weight heparin (Lovenox).

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