The Big 6 Heart Medications

What each pill does for you

Physicians today have an arsenal of medications they can prescribe to help their patients in the battle against heart disease. If you are a heart patient, you can expect to be taking one or more of these highly effective medications.

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As a heart patient, it’s important to understand what each medication does and how to use them safely, often in combination. When used appropriately and according to the proper prescription, these medications extend both quantity and quality of life by preventing heart attacks and strokes.

Modern heart drug therapy includes the following “big six” medications:

1. Statins — to lower LDL cholesterol

Statins were first introduced in 1987 and doctors now have seven different medications from which to choose depending on a patient’s need. They lower the “bad” LDL cholesterol levels by 20 to 60 percent and also reduce inflammation. Most people who have had a heart attack or stroke, bypass surgery, stents, or diabetes should be taking statins. Some patients with a high LDL level, but without heart disease, should also take statins.

2. Aspirin — to prevent blood clots


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Aspirin has been around for a long time and was first discovered to have cardiovascular benefits in the 1960s. Aspirin can help to keep arteries open because of its anti-clotting and anti-platelet effects. A standard dosage for heart patients is 81 mg a day, which is one baby aspirin. Aspirin makes sense for people who already have heart disease, but not necessarily for people who just have risk factors.

3. Clopidogrel — to prevent blood clots

This drug is considered a “super-aspirin” because of its effectiveness in preventing platelet clumping and it is often used in combination with aspirin. For some patients there is an increased risk of bleeding and doctors will weigh the benefits versus the risks of this drug. However, for patients with stents, the combination of aspirin and clopidogrel is essential to preventing clotting. It is also often used for patients with worsening angina.

4. Warfarin — to prevent blood clots

This drug is a stronger anti-clotting agent than aspirin and clopidogrel. It works as an anticoagulant – or blood thinner. Warfarin is widely used to prevent the formation of clots for patients with atrial fibrillation, those with artificial heart valves and those who have formed blood clots in veins of the legs. Because it interacts with other medications and diet, it requires close monitoring by a physician.

5. Beta-blockers — to treat heart attack and heart failure and sometimes used to lower blood pressure

Beta-blockers block the effects of adrenaline, which comes on in response to stressful situations. Beta-blockers are prescribed in the treatment of these four conditions—angina, heart attack, congestive heart failure and abnormal heart rhythms. Dosage must be adjusted for the desired response and doctors will monitor for dizziness (due to low heart rate), and kidney and liver problems.

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6. ACE inhibitors — to treat heart failure and lower blood pressure

ACE (angiotensin-converting enzyme) inhibitors prevent the body from producing the artery-constricting hormone angiotensin. Arteries relax with ACE inhibitors and this lowers blood pressure. They are prescribed for patients with congestive heart failure, a recent heart attack, and those with hypertension.

Heart 411Collectively, these drugs are saving lives by preventing heart attacks and strokes. Chances are you will take one or more these medications if you are at risk for or have coronary heart disease. Be sure to know your medications and follow your doctor’s instructions. You will want to work with him or her to get the safe and effective combination for you.

The information in this article is summarized from the book Heart 411 by Marc Gillinov, MD, and Steven Nissen, MD, of Cleveland Clinic’s Heart & Vascular Institute.

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