How do common heart medications work?
It's estimated that about five to seven million Americans suffer from heart disease. Nearly half a million new cases occur each year with 40,000 deaths annually. This creates a serious burden on families, hospitals and Medicare. But not all heart conditions are the same, resulting in a wide range of common heart medications with a variety of functions including: helping reduce blood clots, opening veins and vessels, ridding the body of excess water, lowering cholesterol and regulating heartbeat. Some medicines work directly on the heart, and others target the liver, kidneys or blood circulation.
What is the Chemical Action of Heart Medications?
Heart medications fall into the following categories: angiotension-converting enzyme (ACE) inhibitors, angiotension receptor blockers (ARBs), antiarrhythmics, anticoagulants, antihypertensives, aspirin, beta blockers, digitalis, diuretics, lipid-lowering medications and nitrates.
These heart medications work in different ways:
- ACE inhibitors target the chemical angiotension II to block its production. Angiotension is a protein that drives blood pressure up by causing blood vessels to constrict. ACE inhibitors help blood vessels to dilate, thus lowering blood pressure.
- ARBs also target angiotension II but work by stopping its affects on the body once it's produced. As with ACE inhibitors, the blood vessels dilate and pressure is reduced.
- Antiarrhythmics suppress fast rhythms of the heart.
- Anticoagulants help reduce the risk of blood clotting which can lead to thrombosis.
- Antihypertensives (and calcium channel blockers) are used to reduce high blood pressure.
- Aspirin helps prevent strokes and heart attacks by inhibiting the function of platelets and thus having an antithrombotic effect.
- Beta blockers lower pressure by slowing down the heart's contractions.
- Digitalis helps to control an irregular or fast heart rate. It also acts as a diuretic—increasing urine production by helping circulation through the kidneys.
- Lipid-lowering medications (statins) help to lower low density lipoprotein (LDL); colloquially called “bad cholesterol.” High LDL levels can lead to atherosclerosis due to plaque buildup in the arteries.
- Nitrates (such as nitroglycerin) work as vasodilators—widening veins to help the flow of oxygen and blood to the heart.
Prescribing heart medications can be a complicated process as multiple drugs often have to be used in combinations. The chemical action of heart medications produces a range of side effects from nausea to difficulty swallowing to swelling of the face or joints and other serious conditions. Many of the features being affected by heart medications are needed in the body for normal cell or organ function.
For example, diuretics may remove too much necessary fluid and potassium from the body, putting the kidneys at risk. Blood-thinning medications put the body at risk of bleeding excessively. By reducing the heart rate, beta blockers decrease the amount of oxygen circulating through the body.
Your physician needs to work closely with you to find the right dosages and combinations that suit not only your condition but your metabolism. A good practice is to keep a strict record of all medications prescribed—dosages, dates and times of day, side effects and their severity and how your body is reacting. Only you know how the medication makes you feel.
Remember, you are not limited to what has been prescribed. There are many variations of heart medications with different brand names. For your heart's sake, be proactive.