CARDIOVASCULAR DRUGS

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

fibrillation.

Cholesterol-binding drugs—bind to dietary cholesterol and prevent its uptake from the

gastrointestinal tract.

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)

quinapril (Accupril)

ramipril (Altace)

ANGIOTENSIN II RECEPTOR BLOCKERS

irbesartan (Avapro)

losartan (Cozaar)

valsartan (Diovan)