Commonly prescribed include:

• Aspirin
• Clopidogrel (Plavix^®)
• Dipyridamole
• Prasugrel (Effient)
• Ticagrelor (Brilinta)

What the Medication Does:
Keeps blood clots from forming by preventing blood platelets from sticking together. Reason for Medication:

• Helps prevent clotting in patients who have had a heart attack, unstable angina, ischemic strokes, TIA(transient ischemic attacks, or "little strokes") and other forms of cardiovascular disease.
• Usually prescribed preventively when plaque buildup is evident but there is not yet a major obstruction in the artery.
• Certain patients will be prescribed aspirin combined with another antiplatelet drug – also known as dual antiplatelet therapy (DAPT).

Dual Antiplatelet Therapy (DAPT):
Patients who have had heart attacks, patients who are treated with stents in their coronary arteries, and some patients who undergo coronary artery bypass graft surgery (CABG) are treated at the same time with two types of antiplatelet agents to prevent blood clotting. This is called dual antiplatelet therapy (DAPT). One antiplatelet agent is aspirin. Almost everyone with coronary artery disease, including those who have had a heart attack, stent, or CABG are treated with aspirin for the rest of their lives. A second type of antiplatelet agent, called a P2Y₁₂ inhibitor, is usually prescribed for months or years in addition to the aspirin therapy. The type of medication and the duration of your treatment will vary based on a discussion with your healthcare provider weighing the risks of potential bleeding complications.

• If you did not have a heart attack, but have atherosclerosis in your coronary arteries and had a stent placed, you should be on clopidogrel for at least 1-6 months, depending on the type of stent which was placed, risk of clotting the stent, and bleeding risk.
• If you had a heart attack and a coronary artery stent placed, or you are being medically managed for your heart attack (specifically non-ST elevation myocardial infarction (NSTEMI), you should be on a P2Y₁₂ inhibitor for approximately 6-12 months. In some cases, it may be advisable to be on DAPT for a longer duration. This will need to be discussed with your healthcare provider. There are three P2Y₁₂inhibitors that doctors prescribe, which are clopidogrel, prasugrel, and ticagrelor. Studies have shown that two of these drugs (ticagrelor, prasugrel) are “stronger” than clopidogrel, and are a little better at decreasing the complications of blood clots. These two stronger agents, however, slightly increase bleeding. One of these drugs (prasugrel) should not be used by patients who have had a stroke or a transient ischemic attack (TIA). Which one these medications your doctor prescribes will be based on what he or she feels is best for you, based on your risk of blood clots and bleeding. For example, according to the FDA, clopidogrel does decrease the risk of stroke and MI, but does not change the risk of death for specific patients. So, the choice of what type of medication, cost of the medication and duration of treatment will be determined in conjunction with your healthcare provider.
• Some patients who undergo coronary artery bypass surgerymay be treated with a P2Y₁₂ inhibitor for a year after the bypass operation. After this, the P2Y₁₂ inhibitor may be stopped, but the patient continues on aspirin. Your surgeon will discuss if this treatment will be needed.

These are general recommendations for the duration and type of dual anti-platelet therapy which should be used after coronary artery stenting, heart attack and CABG. Again, it is important to talk to your doctor about your specific treatment plan.

Commonly prescribed include:

• Benazepril (Lotensin)
• Captopril (Capoten)
• Enalapril (Vasotec)
• Fosinopril (Monopril)
• Lisinopril (Prinivil, Zestril)
• Moexipril (Univasc)
• Perindopril (Aceon)
• Quinapril (Accupril)
• Ramipril (Altace)
• Trandolapril (Mavik)

What the Medication Does:
Expands blood vessels and decreases resistance by lowering levels of angiotensin II. Allows blood to flow more easily and makes the heart's work easier or more efficient.

Reason for Medication:

• Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and heart failure.

Also known as ARBs or Angiotensin-2 Receptor Antagonists)

Commonly prescribed include:

• Candesartan (Atacand)
• Eprosartan (Teveten)
• Irbesartan (Avapro)
• Losartan (Cozaar)
• Telmisartan (Micardis)
• Valsartan (Diovan)

What the Medication Does:
Rather than lowering levels of angiotensin II (as ACE inhibitors do) angiotensin II receptor blockers prevent this chemical from having any effects on the heart and blood vessels. This keeps blood pressure from rising.

Reason for Medication:

• Used to treat or improve symptoms of cardiovascular conditions including high blood pressure and heart failure.

 

ARNIs are a new drug combination of a neprilysin inhibitor and an ARB.

Commonly prescribed include:

• Sacubitril/valsartan (Entresto)

What the Medication Does:
Neprilysin is an enzyme that breaks down natural substances in the body that open narrowed arteries. By limiting the effect of neprilysin, it increases the effects of these substances and improves artery opening and blood flow, reduces sodium (salt) retention, and decreases strain on the heart.

Reason for Medication:

• For the treatment of heart failure

(Also known as Beta-Adrenergic Blocking Agents)

Commonly prescribed include:

• Acebutolol (Sectral)
• Atenolol (Tenormin)
• Betaxolol (Kerlone)
• Bisoprolol/hydrochlorothiazide (Ziac)
• Bisoprolol (Zebeta)
• Metoprolol (Lopressor, Toprol XL)
• Nadolol (Corgard)
• Propranolol (Inderal)
• Sotalol (Betapace)

What the Medication Does:
Decreases the heart rate and cardiac output, which lowers blood pressure and makes the heart beat more slowly and with less force.

Reason for Medication:

• Used to lower blood pressure.
• Used with therapy for cardiac arrhythmias (abnormal heart rhythms) and in treating chest pain (angina).
• Used to prevent future heart attacks in patients who have had a heart attack.

Combined alpha and beta-blockers are used as an IV drip for those patients experiencing a hypertensive crisis. They may be prescribed for outpatient high blood pressure use if the patient is at risk for heart failure.

• Generic name - carvedilol, Common brand names - Coreg*
• Generic name - labetalol hydrochloride, Common brand names - Normodyne*, Trandate*

A noted possible side effect of combined alpha and beta-blockers:

• May cause a drop in blood pressure when you stand up

(Also known as Calcium Antagonists or Calcium Blockers)

Commonly prescribed include:

• Amlodipine (Norvasc, Lotrel)
• Diltiazem (Cardizem, Tiazac)
• Felodipine (Plendil)
• Nifedipine (Adalat, Procardia)
• Nimodipine (Nimotop)
• Nisoldipine (Sular)
• Verapamil (Calan, Verelan)

What the Medication Does:
Interrupts the movement of calcium into the cells of the heart and blood vessels. May decrease the heart's pumping strength and relax blood vessels.

Reason for Medication:

• Used to treat high blood pressure, chest pain (angina) caused by reduced blood supply to the heart muscle and some arrhythmias (abnormal heart rhythms).

Common types of cholesterol-lowering drugs include:

• Statins: Atorvastatin (Lipitor), Rosuvastatin (Crestor)
• Nicotinic Acids: Lovastatin (Advicor(
• Cholesterol Absorption Inhibitors: Ezetimibe/Simvastatin (Vytorin)

What the Medication Does:
Various medications can lower blood cholesterol levels, but drug other than statins should only be used for patients in whom statins are not effective enough or who have serious side effects due to statin therapy. They work in the body in different ways. Some affect the liver, some work in the intestines and some interrupt the formation of cholesterol from circulating in the blood.Watch an animation of how statins work.

Reason for Medication:
Used to lower LDL ("bad") cholesterol.

(Also known as Digoxin and Digitoxin)

Commonly prescribed include:

• Lanoxin

What the Medication Does:
Increases the force of the heart's contractions, which can be beneficial in heart failure and for irregular heartbeats.

Reason for Medication:

• Used to relieve heart failure symptoms, especially when the patient isn't responding to ACE inhibitors and diuretics.
• Also slows certain types of irregular heartbeat (arrhythmias), particularly atrial fibrillation.

(Also known as Water Pills)

Commonly prescribed include:

• Amiloride (Midamor)
• Bumetanide (Bumex)
• Chlorothiazide (Diuril)
• Chlorthalidone (Hygroton)
• Furosemide (Lasix)
• Hydro-chlorothiazide (Esidrix, Hydrodiuril)
• Indapamide (Lozol)
• Spironolactone (Aldactone)

What the Medication Does:
Causes the body to rid itself of excess fluids and sodium through urination. Helps to relieve the heart's workload. Also decreases the buildup of fluid in the lungs and other parts of the body, such as the ankles and legs. Different diuretics remove fluid at varied rates and through different methods.

Reason for Medication:

• Used to help lower blood pressure.
• Used to help reduce swelling (edema) from excess buildup of fluid in the body.

(Also known as Nitrates. Nitroglycerin tablets are a form of vasodilator.)

Commonly prescribed include:

• Isosorbide dinitrate (Isordil)
• Nesiritide (Natrecor)
• Hydralazine (Apresoline)
• Nitrates
• Minoxidil

What the Medication Does:
Relaxes blood vessels and increases the supply of blood and oxygen to the heart while reducing its workload. Can come in pills to be swallowed, chewable tablets and as a topical application (cream).

Reason for Medication:

• Used to ease chest pain (angina).