Heart disease is the No. 1 killer of people in the United States. A diagnosis of heart disease doesn't spell out certain doom, however. Exercise and a healthy diet are one way to fight it, and fortunately, nowdays there are many safe and effective drug treatments as well. Some are new, some are old, and some work when others don't. Your doctor will know which is the best drug (or drugs) for you, but it helps to be informed so you can take part in your own health care (and heart care) planning.
Let's take a look at 10 weapons against heart disease that we have in the modern medicine arsenal.
When oxygen-rich blood is having a tough time getting to the far corners of your body for whatever reason, the body intentionally increases blood pressure to get the job done. One of the ways it does this is by narrowing blood vessels. A specialized enzyme -- angiotensin II -- spurs the muscle tissue surrounding blood vessels to contract, thus narrowing the vessels and raising blood pressure.
We all know, however, that high blood pressure can lead to very serious health risks. One way to prevent high blood pressure is to take ACE inhibitors. These drugs prevent the formation of the enzyme (angiotensin converting enzyme, or ACE) that helps produce angiotensin II. By keeping these enzymes from forming, the drug causes the blood vessels to become larger, dropping your blood pressure back to where it needs to be.
When water and sodium build up in the body, the body (especially the extremities) swells up, causing a condition known as edema. The excess water and salt also play a part in constricting blood vessels, hampering the passage of oxygen-rich blood. Diuretics are sometimes prescribed as a means of prompting a brief period (generally, several hours) of increased urination, ridding the body of the unneeded water and sodium. This relaxes the blood pressure walls, lowering blood pressure. It's an especially effective means of offering relief to those who have swelling in their legs. Diuretics are usually the first thing doctors reach for when treating high blood pressure.
ACE inhibitors aren't the only way to relax the blood vessels. Vasodilators are a type of drug that tells the smooth muscle tissue in a blood vessel to relax, kick up its heels and take a load off. As these tiny muscle fibers relax throughout the system, the heart finds it a lot easier to pump blood throughout the body, and blood pressure decreases.
One issue with vasodilators is that they can work too well. Taking them can result in a sudden drop in blood pressure, leaving you seeing stars, sitting down and seeking medical assistance.
These drugs aren't usually used by themselves to treat high blood pressure -- they're often prescribed along with other heart drugs, such as beta blockers, diuretics or ACE inhibitors.
One of the symptoms of congestive heart failure is swelling of the extremities, which we know as edema. In the 18th century, this swelling symptom was called dropsy (but no one knew what caused it).
An English doctor, William Withering, published a paper in 1785 describing how the ground-up leaves of the foxglove plant seemed to resolve swelling in many patients. It would be another century before the connection was made between heart failure and edema.
Digitalis, which is derived from the foxglove plant, lowers heart rate and strengthens the heart's contractions. It's also used to treat people with abnormal heart rhythms. Digitalis is a serious drug, though -- levels of it in the body have to be monitored closely, because too much can lead to severe side effects, including death. Even if symptoms pass, patients are often kept on digitalis medications indefinitely, so know that when you start.
When you get a jolt of adrenaline coursing through your body, you may be in the process of evading a lion -- or sneaking back into your workplace after a long lunch break. Regardless, the adrenaline increases the force with which your heart beats, speeds up your heart rate and increases your blood pressure.
But even if you aren't rushing into a burning building to save lives, you have an ever-present level of adrenaline in your system that increases or decreases according to what your body thinks you need.
Beta blockers lower blood pressure by blocking the effects of adrenaline (also known as epinephrine). As the effects of adrenaline are neutralized, blood vessels open up, heart rate slows down and the heart beats less forcefully (but pumps with better efficiency).
Officially known as anticoagulants, blood thinners themselves don't thin the blood at all. The drugs work by reducing levels of vitamin K in the blood.
The liver uses vitamin K to produce blood-clotting agents. When you mix blood clots and narrowed blood vessels, it can lead to strokes and heart attacks. By reducing the supply of vitamin K to the liver, blood-thinning drugs reduce the body's ability to form potentially troublesome blood clots.
Patients who receive man-made valve replacements or stents are often put on blood thinners to prevent clots from forming on the new component. No matter the reason for taking them, doctors must be very careful in determining the dosage since too much of a blood-thinning agent can lead to internal bleeding. A word to the wise -- tell your doctor and your dentist that you're on blood thinners before any medical or dental procedure.
Angiotensin II, the substance we mentioned earlier, is a chemical that binds to receptors on blood vessels, causing them to contract. Often, doctors prescribe ACE inhibitors to prevent the formation of the enzyme (angiotensin I) that's responsible for producing angiotensin II. But ACE inhibitors don't work for everyone, and some patients have trouble with the side effects (which can include kidney failure). In such cases, doctors may opt to prescribe angiotensin II receptor blockers, or ARBs.
While ACE inhibitors prevent angiotensin II from forming, ARBs prevent it from working. How? ARBs stop angiotensin II from reaching its specialized receptors, located on the exterior of blood vessels. This keeps them floating nearby, where they can't do any harm.
Sometimes a person with heart disease will experience tightness in the chest, which is called angina. This isn't a heart attack, but it's definitely a major warning that one could be on its way. Angina occurs when the heart isn't receiving enough oxygen to function properly. One way of relieving angina is through the use of calcium channel blockers (CCBs).
CCBs relax the blood vessels and help expand the arteries, allowing more oxygenated blood to pass to and from the heart. By doing so, CCBs lower blood pressure. They also prevent calcium from penetrating blood vessel walls. This is important because calcium hardens the blood vessels, diminishing their function and creating more work for the heart.
Some CCBs work quickly, but the effects don't last long, while others work slowly over time, with longer-lasting effects.
Potassium is important to every cell and tissue in your body. Its quality as an electrolyte means that it enables electrical signals to transmit across cells. This is critical for all muscle contraction, and especially so for the heart muscle. Without an electrical signal prompting the heart to contract, there would be no blood pumping through your body.
You can find potassium in meat, fish, dairy, vegetables and fruits -- bananas, for example, are an excellent source. Too little potassium in the body is a bad thing, but so is too much. Having too much (a condition known as hyperkalemia) is more of a concern as you age because kidney function decreases, meaning less potassium is removed from the body. Some good news? Studies indicate that consuming twice as much potassium as sodium -- regardless of the amounts of either -- improves heart health.
Cholesterol -- specifically low-density lipoproteins (LDLs, or "bad" cholesterol) -- builds up over time on the inner walls of your arteries, narrowing these primary passageways and forcing the heart to work harder to move the same quantity of oxygen-rich blood to the rest of the body. Since healthy arteries are crucial to heart health, many doctors prescribe cholesterol-lowering drugs to heart patients.
Some of these drugs:
- Statins diminish the liver's ability to produce new cholesterol.
- Cholesterol absorption inhibitorsprevent cholesterol from being absorbed by the small intestine, which would allow it to be returned to the liver and recycled.
- Bile acid resins bind to bile, disabling its function in digestion. The body then produces more bile, using cholesterol to do so -- which gets rid of the cholesterol.
- Niacin raises levels of "good" cholesterol.
- Fibrates lower blood fats that contribute to cholesterol levels.
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