Common Heart Medications and What They Do

Heart medications target many of the factors that contribute to heart disease, from high blood pressure (BP) and cholesterol to blood clots and fluid retention. They work to treat current issues and lower your risk of serious problems down the road.

If you have heart disease — or are at high risk for it — you may even take more than one medication. Tens of millions of people in the U.S. take some combination of medicines to protect against cardiovascular issues.

“Collectively, these medications save lives by preventing heart attacks and strokes,” says cardiologist Leslie Cho, MD.

Common types of heart medications

There’s no one-size-fits-all prescription for protecting your heart. The medications your healthcare provider recommends depend on your diagnosis, personal risk factors and overall health.

Many prescribed drugs work well together to address concerns, says Dr. Cho. For example, one might lower your blood pressure while another may manage cholesterol or help prevent blood clots.

Here are some of the most common types of heart medications, sorted by the jobs they do.

Blood pressure and heart workload management

High blood pressure makes your heart work harder to move blood through your body. Over time, that extra strain takes a toll on your heart and blood vessels. That can increase your risk of a heart attack or heart failure, among other concerns.

Several types of medications can help lower blood pressure or reduce the demands placed on your heart. Among the most commonly prescribed are:

• ACE inhibitors: Angiotensin-converting enzyme (ACE) inhibitors reduce the body’s production of angiotensin II, a hormone that narrows blood vessels. This helps blood vessels relax and widen, which lowers blood pressure. ACE inhibitors are commonly prescribed for people with high blood pressure or heart failure.
• ARBs: Angiotensin II receptor blockers (ARBs) also target angiotensin II, but in a different way from ACE inhibitors. Instead of reducing its production, they block its effects. The result is similar: ARBs help relax blood vessels and lower blood pressure.
• Beta-blockers: These drugs block the effects of adrenaline to slow your heart rate and reduce how hard your heart has to work. They’re used to treat conditions like heart failure and some abnormal heart rhythms. They can also help lower BP.
• Calcium channel blockers: These medicines affect how calcium enters the muscle cells in your heart and blood vessels. Depending on the type, they can relax blood vessels, lower blood pressure or slow your heart rate.

Cholesterol reduction

Cholesterol-reducing medications aren’t just about improving a number on your lab report. Lowering LDL (“bad”) cholesterol can help reduce the risk of cardiovascular events (like a heart attack) or stroke.

This category includes:

• Statins: These are often taken as a preventive measure to lower LDL cholesterol and your risk of future heart problems. They’re commonly prescribed if you’ve had a heart attack, stroke or procedures such as bypass surgery or stent placement. They may also help reduce inflammation.
• Other lipid-lowering medications: Your healthcare provider may prescribe other medicines when statins alone don’t lower your cholesterol enough, or if you can’t take a statin. They work in different ways to lower LDL cholesterol or other blood fats. Examples include ezetimibe and PCSK9 inhibitors.

Blood clot prevention

A blood clot can block blood flow to your heart or brain and cause a heart attack, stroke or other issue. Certain heart conditions and procedures can increase the risk of dangerous clots, so your healthcare provider may prescribe medication to make clots less likely.

You may hear these types of drugs casually called “blood thinners,” but they don’t actually make your blood thinner. Instead, they interfere with different parts of the clotting process.

Two major types are:

• Antiplatelet medications: These drugs help keep platelets — tiny blood cells involved in clotting — from sticking together and forming clots. Examples include aspirin and clopidogrel. Aspirin may be recommended for some people who already have heart disease, but it’s generally not used to prevent a first cardiovascular event.
• Anticoagulants: These medications interfere with the process your body uses to form blood clots. Warfarin is an older example. Dr. Cho notes that it’s no longer typically the first-line medication for blood clots in the legs or lungs. Newer oral anticoagulants, such as apixaban and rivaroxaban, are now often used for those conditions. Warfarin remains important for certain heart valve conditions.

Both can increase your risk of bleeding. That’s why they should be taken only as prescribed and shouldn’t be started or stopped without talking with your healthcare provider.

Heart rhythm

Antiarrhythmics can help control an abnormal heart rhythm. Different antiarrhythmics work in different ways, so the prescribed medicine depends on the type of rhythm problem you may have.

Beta-blockers may also be used to manage certain abnormal heart rhythms.

Fluid control

Fluid buildup can put extra strain on your heart. Diuretics help your body get rid of excess sodium and fluid. This can ease the burden on your heart and relieve buildup associated with heart failure.

Diuretics are often called “water pills.”

How to manage your heart medications

Taking several heart medications can feel like a lot to keep straight. Following these five suggestions from Dr. Cho can help you stay on top of it and improve your chances of a healthy outcome.

1. Know what you take and why. Keep an up-to-date list of your medications, dosages and what each one does.
2. Take medications exactly as prescribed. Don’t change your dose, skip doses or stop a heart medicine because you’re feeling better. Talk to your healthcare provider if you have any concerns about what or how much you’re taking.
3. If you miss a dose, take it as soon as you remember unless it’s almost time for your next dose. If so, skip the missed dose and take the next one at the usual time. Don’t take two doses at once unless your healthcare provider gives an OK.
4. Ask about side effects. Some heart medications require adjustments or monitoring. Talk to your doctor or pharmacist about possible side effects and what to watch for.
5. Check before adding other medicines or supplements. Prescription drugs, over-the-counter products and supplements can interact with heart medications. Always ask if there’s potential for problems.
6. Keep up with follow-up care. Blood tests, blood pressure checks and other monitoring can help your care team know whether your medications are working safely and effectively.

Know that your medication regimen may change as your health changes, too. What matters is working with your healthcare team to find the combination that provides the most benefit with the fewest risks.

“You’ll want to work with them to get a safe and effective combination for you,” says Dr. Cho.