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Our Heart Health medication section contains a wide range of medications used to treat and/or prevent various cardiovascular conditions, including, angina, congestive heart failure, hypertension (high blood pressure), high cholesterol, atherosclerosis (blocked arteries), peripheral artery disease, and (thrombosis).
The different classes of Heart Health medication are listed on the left of the page and when you click on one of these, the principal brand name products display in the left column and generic alternatives to the right.
Our ACE Inhibitors class of Heart Health medications are used to treat hypertension (high blood pressure) to prevent heart attack and stroke; also to treat congestive heart failure and reduce water retention in the tissues (oedema).
Angiotensin is a naturally produced hormone that forms part of a complex interaction of hormones, known as the renin-angiotensin hormone system that regulates blood volume, body fluid levels and blood pressure. Angiotensin is produced by the liver as angiotensinogen, which is converted to angiotensin I by the action of renin, released by the kidney when blood pressure and volume is low. Angiotensin I is the inactive precursor for Angiotensin II, which is produced by the action of Angiotensin Converting Enzyme (ACE) mainly in the lungs, but also in the kidney and endothelial cells lining the blood vessels.
Angiotensin II is a highly vasoactive hormone that has potent effects on blood pressure and fluid balance. It stimulates vascular smooth muscle to contract, which causes blood vessels to constrict (narrow). This increases blood volume while at the same time reducing blood vessel volume, which increases blood pressure. Angiotensin II also stimulates the production of the hormone aldosterone from the adrenal gland. Aldosterone stimulates the tubule cells of the kidney to reabsorb salt (sodium and potassium) and water from the blood, which also increase blood volume and pressure.
If the renin-angiotensin is out of balance, then blood pressure will remain too high and can result in hypertension, heart failure and kidney failure. This is why angiotensin is the target of several drugs for cardiovascular disease, including ACE inhibitors that prevent the formation of angiotensin II from Angiotensin I.
ACE inhibitors are used to treat hypertension and congestive heart failure and work by inhibiting the action of Angiotensin Converting Enzyme and this action reduces blood volume, widens blood vessels and lowers blood pressure. They also reduce the production of aldosterone, which reduces uptake of salt and water by the kidneys and reduces blood volume and fluid retention in the tissues. ACE inhibitors also prevent the degradation of bradykinin, which further lowers blood pressure.
Our Anti-Clotting/Anticoagulants class of Heart Health medications are used to prevent blood clot formation or thrombosis, and reduce risk of heart attack stroke and pulmonary embolism.
Anti-clotting and anticoagulant medications (antithrombotic) are used to prevent the formation of a blood clot or thrombosis in conditions where it could be life threatening, such as cardiovascular disease, congestive heart failure, atrial fibrillation and reduced blood flow due to immobility.
Antiplatelet drugs like clopidogrel work by binding to the ADP receptor on the platelet surface and inhibiting the activation of platelet aggregation.
Our Angiotensin II receptor blockers class of Heart Health medications are used to treat hypertension (high blood pressure) to prevent heart attack and stroke; also to treat and heart failure and help relieve symptoms.
The binding of Angiotensin II to the Angiotensin receptor (AR) activates the receptor and this mediates all the actions of Angiotensin II via a series of trans-membrane and intracellular signal transduction systems, including activation or inhibition of enzymes (activation of phospholipases C and A2 and tyrosine kinases, inhibition of adenylate cyclase) and opening of calcium channels.
The angiotensin receptor (AR) is a target for antihypertensive drugs since blocking the receptor also blocks all the actions of Angiotensin II that happen as a result of activation of the AR. Angiotensin receptor blockers (ARBs) cause vasodilation or widening of the blood vessels, which reduces blood pressure. They also reduce the production of aldosterone, which reduces uptake of salt and water by the kidneys, blood volume and fluid retention in the tissues, and therefore, ARBs are suitable for treating congestive heart failure.
Calcium channel blockers are used to treat hypertension and reduce symptoms of cardiovascular disease, such as angina.
Our Diuretics class of Heart Health medications are used to reduce oedema (water retention) in various conditions including hypertension (high blood pressure) and cardiovascular disease to prevent heart attack and stroke; also for various cardiovascular conditions like angina, heart failure, and thrombosis.
Diuretics (also known as water tablets) are used to
treat oedema and there are different mechanisms of action that the various diuretics
The diuretics frusemide,
amiloride and hydrochlorothiazide act directly on the kidneys to promote the
removal of salts and water from the blood, which increase the urine volume and
decreases blood volume. This action
draws water out of the tissues and reduces resistance to blood flow in peripheral
arteries, which reduces oedema and also helps lower blood pressure.
Spironolactone has a
different mechanism of action and acts as an antagonist of aldosterone, a
hormone that promotes the reuptake of salts by the kidneys at the distal end of
the kidney tubules. Spironolactone is
known as a potassium sparing
diuretic as it promotes fluid
loss from the body but also reduces loss of potassium, which can happen with
Our Vasodilators class of Heart Health medications are used to relax and widen blood vessels in the treatment of hypertension (high blood pressure) to reduce risk of cardiovascular diseases to prevent heart attack and stroke.
Vasodilators are used to treat several conditions in which vasodilation helps improve the condition. These include:
Blood pressure is the force needed to pump blood around the body. Blood pressure measurements are divided into systolic pressure, which is when the heart contracts forcing blood out into the arteries, and diastolic when the heart rests and fills with blood. Blood pressure measurement is expressed as systolic pressure over diastolic pressure. Hypertension is high blood pressure at rest and causes reduced blood flow, increases the force needed to pump blood around the body, increases workload on the heart and increases oxygen demand. This can cause damage to blood vessels as well as end organ tissue damage to the kidneys, eyes and nerves. Hypertension also increases risk of cardiovascular disease, including stroke and heart attack.
Angina is a symptom of coronary artery disease when the heart does not get enough oxygen and compensates by pumping harder and faster. Symptoms include discomfort or pain in the chest and breathlessness on exertion. Angina is not the same as heart attack as it is not caused by a blockage only a narrowing of the arteries and there is no permanent damage to the heart muscle.
Several classes of vasodilator are available that work by different mechanism of action.
Our Others class of Heart Health medications contain medications that do not fall into one of the other categories but are also are used to treat hypertension (high blood pressure) and cardiovascular disease to prevent heart attack and stroke; also for various cardiovascular conditions like angina, heart failure, and arrhythmias.
Blood pressure is the force needed to pump blood around the body. Blood pressure measurements are divided into systolic pressure, which is when the heart contracts forcing blood out into the arteries, and diastolic when the heart rests and fills with blood. Blood pressure measurement is expressed as systolic pressure over diastolic pressure.
is high blood pressure at rest and causes reduced blood flow, increases the force needed to pump blood around the body, increases workload on the heart and increases oxygen demand. This can cause damage to blood vessels as well as end organ tissue damage to the kidneys, eyes and nerves. Hypertension also increases risk of cardiovascular disease, including stroke and heart attack.
Adrenergic receptors bind to specific chemicals
that cause contraction of blood vessel walls or vasoconstriction, like the
neurotransmitters adrenaline and noradrenaline.
Vasoconstriction increases resistance to blood flow, which increases
blood pressure. Vasodilation or
relaxation of blood vessels reduces resistance to blood flow, which lowers
Adrenergic receptors exist as alpha and beta
forms and alpha receptors have the subtypes alpha1 and alpha 2. Both alpha subtypes are found in smooth
muscle such as in blood vessels and promote vasoconstriction in response to
binding of adrenaline and noradrenaline to the receptor. Alpha 2 receptors are also found in the
central nervous system, where they inhibit the release of adrenaline and
noradrenaline when activated.
Several drugs are used to treat high blood pressure by interacting with alpha adrenergic receptors:
Cardiac muscle is a type of muscle only found in the heart and contraction of cardiac muscle propels blood through the chambers of the heart and around the body. Heart failure is a condition in which the heart muscle no longer pumps efficiently and results in symptoms including shortness of breath and oedema (water retention in the tissues) causing swelling. Arrhythmias like atrial fibrillation result in irregular heart beat and are caused by abnormal electrical activity in the heart.
Drugs known as cardiac glycosides, like digoxin act directly on the heart muscle to slow down the rate but increase the force of contraction to improve pumping efficiency, which helps reduce symptoms of heart failure.
Heart health is compromised by cardiovascular disease, which affects the heart or blood vessels and can be caused by an infection, inflammation or a genetic predisposition. However, the main causes and risk factors are:
Several medications are available for treating hypertension and cardiovascular conditions. They have different mechanisms of action often to achieve the same result, so that a particular type of medication can be used for several conditions with similar causes. Some medications however, are used only for a specific condition and some can be used together for increased effectiveness.
The various classes of cardiovascular medications include: