Cardiovascular drugs act on the heart or the blood vessels to treat hypertension, angina
(pain due to decreased oxygen delivery to heart muscle), myocardial infarction (heart
attack), congestive heart failure, and arrhythmias. Often, before other drugs are used, daily
aspirin therapy (to prevent clots in blood vessels) and sublingual nitroglycerin (to dilate
coronary blood vessels) are prescribed. Digoxin (Lanoxin) helps the heart pump more
forcefully in heart failure. Other cardiovascular drugs include:
Angiotensin-converting enzyme (ACE) inhibitors—dilate blood vessels to lower blood
pressure, improve the performance of the heart, and reduce its workload. They
prevent the conversion of angiotensin I into angiotensin II, which is a powerful
vasopressor (vasoconstrictor). ACE inhibitors reduce the risk of heart attack, stroke,
heart failure and death even if a patient is not hypertensive.
Angiotensin II receptor blockers (ARBs)—lower blood pressure by preventing
angiotensin from acting on receptors in blood vessels. They are used in patients
who do not tolerate ACE inhibitors. An exciting new combination antihypertensive
drug to treat heart failure is Entresto, formerly known as LCZ696. It combines two
agents: valsartan and sacubitril.
Antiarrhythmics—reverse abnormal heart rhythms. They slow the response of heart
muscle to nervous system stimulation or slow the rate at which nervous system
impulses are carried through the heart.
Beta blockers—decrease muscular tone in blood vessels (leading to vasodilation), slow
heart rate, decrease output of the heart, and reduce blood pressure by blocking the
action of epinephrine at receptor sites in the heart muscle and in blood vessels. Beta
blockers are prescribed for angina, hypertension, arrhythmias (such as fibrillation),
and prevention of a second heart attack.
Calcium channel blockers—dilate blood vessels and lower blood pressure and are used
to treat arrhythmias. They inhibit the entry of calcium (necessary for blood vessel
contraction) into the muscles of the heart and blood vessels.
Cardiac glycosides—made from digitalis (foxglove plant). These drugs increase the
force of contraction of the heart and are used to treat heart failure and atrial
Cholesterol-binding drugs—bind to dietary cholesterol and prevent its uptake from the
Cholesterol-lowering drugs (statins)—control hypercholesterolemia (high levels of
cholesterol in the blood), which is a major factor in the development of heart disease.
These drugs lower cholesterol by reducing its production in the liver.
Diuretics—reduce the volume of blood in the body by promoting the kidney to remove
water and salt through urine. They treat hypertension (high blood pressure) and
congestive heart failure.
Examples of cardiovascular drugs are given below:
ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS
enalapril maleate (Vasotec)
lisinopril (Prinivil, Zestril)
ANGIOTENSIN II RECEPTOR BLOCKERS