January 3, 2021/Heart Health

The Big 6 Heart Medications

What each does for you

medications for the heart

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.


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

As a heart patient, it’s important for you 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% 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

Aspirin has been around for a long time and was first discovered to have cardiovascular benefits in the 1960s. Aspirin can help to keep your 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.

But cardiologist Leslie Cho, MD, advises “we should emphasize that it’s really not recommended for primary prevention unless the ischemic benefit outweighs the bleeding risk.”


3. Clopidogrel — to prevent blood clots

This drug is considered a “super-aspirin” because of its effectiveness in preventing platelet clumping, and it’s 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, if you have a stent, the combination of aspirin and clopidogrel is essential to preventing clotting. It’s also often used for patients with worsening angina.

Dr. Cho says if you’ve had acute coronary syndrome, a better option might be Ticagrelor or Prasugrel, however.

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 was widely used in the past to prevent the formation of clots if you have atrial fibrillation, an artificial heart valve or if you have blood clots in your legs.

Dr. Cho says now Warfarin is no longer the first line medication choice for afib or a blood clot in the leg or lungs. It’s primarily used for heart valve disease. And because it interacts with other medications and diet, it requires close monitoring by a physician.

“The first line drug for afib (depending on renal function) is novel oral anticoagulants,” she says.


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.
  • Abnormal heart rhythms.

Dosage of these medications must be adjusted for the desired response. Your doctor will monitor you for dizziness (due to low heart rate) kidney and liver problems.

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.

Collectively, these drugs save lives by preventing heart attacks and strokes. Chances are you will take one or more of 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’ll want to work with them to get the safe and effective combination for you.

Learn more about our editorial process.

Related Articles

Person enjoying container of assorted fruit
February 28, 2024/Heart Health
How To Protect Your Heart When You Have Prediabetes

You can counter the risk of prediabetes-related heart attack or stroke by eating more fruits, vegetables and whole grains, as well as exercising regularly

Cholesterol blocking blood flow in artery
February 26, 2024/Heart Health
What It Means if You Have ‘Sticky’ Cholesterol

LDL cholesterol and lipoprotein (a) cholesterol are more likely to stick to your arteries and lead to dangerous heart events

Doctor shaking hands with patient, with large heart and EKG line behind them
February 19, 2024/Heart Health
How Weight Affects Your Heart

Having underweight, having overweight and having obesity can be dangerous for your heart

Close up of hands holding heart rate wearable watch monitor and their phone
February 12, 2024/Exercise & Fitness
Next Time You Exercise, Consider Wearing a Heart Rate Monitor

This technology can benefit your workouts by helping you hit your target heart rate, resulting in better overall health and wellness

seated doctor and female in doctor office, with female's hand on heart, with daughter
February 8, 2024/Heart Health
Here’s When You Should Go to the Hospital for a Dangerous Heart Rate

A resting heart rate below 35–40 beats per minute or over 100 beats per minute may be cause for concern

healthcare provider speaking with older female in office
February 6, 2024/Women's Health
How Estrogen Supports Heart Health

Your natural estrogen levels support a healthy heart by improving your cholesterol, increasing blood flow and reducing free radicals

Flaxseed sprinkled on a salad in a white bowl on a dark wooden table
January 31, 2024/Nutrition
Flaxseed: A Little Seed With Big Health Benefits

Ground flaxseed is full of heart-healthy omega-3s, antioxidants and fiber, and easy to add to just about any recipe

Older male in doctor's office with doctor holding tablet showing heart statistics
January 31, 2024/Heart Health
Extra Heartbeats: Should You Be Worried?

They’re rarely cause for concern, but you should still talk to a healthcare provider about your symptoms

Trending Topics

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

woman snacking on raisins and nuts
52 Foods High In Iron

Pump up your iron intake with foods like tuna, tofu and turkey