Many different medicines are used to treat CHD. Some heart medicines have side effects, so it may take a while to find one that works for you. Your GP or specialist will be able to discuss the various options with you.
ACE (angiotensin-converting enzyme) inhibitors
ACE inhibitors are commonly used to treat high blood pressure. Examples include captopril and enalapril. They block the activity of a hormone called angiotensin II, which causes the blood vessels to narrow. As well as stopping the heart working so hard, ACE inhibitors improve the flow of blood around the body.
Your blood pressure will be monitored while you are taking ACE inhibitors, and regular blood tests will be needed to check that your kidneys are working properly. Around one in 10 people have kidney problems as a result of taking ACE inhibitors.
If ACE inhibitors have been prescribed for you, do not stop taking them without first consulting you doctor. If you do, it is likely that your symptoms will get worse quickly.
Side effects of ACE inhibitors can include a dry cough, dizziness and fainting.
Angiotensin II receptor antagonists
Angiotensin II receptor antagonists work in a similar way to ACE inhibitors. They are used to lower your blood pressure by limiting angiotensin II. Mild dizziness is usually the only side effect. Angiotensin II receptor antagonists are often prescribed as an alternative to ACE inhibitors, as they do not cause a dry cough.
Calcium channel blockers
Calcium channel blockers also work to decrease blood pressure by relaxing the muscles that make up the walls of your arteries. This causes the arteries to become wider, reducing your blood pressure. Examples include verapamil and diltiazem. Side effects include headache and facial flushing but these are mild and usually decrease over time.
Thiazide diuretics
Diruetics work by reducing the amount of water in your blood and widening your arteries, thereby reducing blood pressure. They are not recommended for pregnant women or people who have gout (a type of arthritis where crystals develop inside the joints).
Thiazide diuretics have been known to reduce the level of potassium in your blood, which can interfere with your heart and kidney functions. They can also raise the level of sugar in your blood, which could lead to diabetes. Therefore, you will probably be recommended to have blood and urine tests every six months so your potassium and blood sugar levels can be monitored.
Beta blockers
Beta blockers, including acebutolol, atenolol, bisprolol, metoprolol and propranolol, are often used to prevent angina and treat high blood pressure. They work by blocking the effects of a particular hormone in the body and this slows down your heartbeat and improves blood flow.
Statins
If you have a high blood cholesterol level, cholesterol-lowering medicine called statins may be prescribed. Examples include simvastatin, pravastatin and atorvastatin. They work by blocking the formation of cholesterol and increasing the number of LDL receptors in the liver, which help to remove the LDL cholesterol from your blood. This helps to slow the progression of CHD, and will make having a heart attack less likely.
Low-dose aspirin
Low-dose aspirin may be prescribed for you by your doctor unless there are reasons not to, e.g. if you have a bleeding disorder. This type of medicine will help prevent your blood clotting and can help to reduce your risk of heart attack and angina.
Nitrates
Nitrates are used to widen your blood vessels. Doctors sometimes refer to nitrates as vasodilators. They are available in a variety of forms, including tablets, sprays, skin patches and ointments, examples include glyceryl trinitrate and isosorbide dinitrate.
Nitrates work by relaxing your blood vessels, letting more blood pass through them. This lowers your blood pressure and relieves any heart pain that you have. Nitrates can have some mild side effects, including headaches, dizziness and flushed skin.
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