Drugs for CAD: A Guide to Medications for Coronary Artery Disease

Coronary artery disease (CAD) occurs when your blood vessels can’t carry enough blood and oxygen to your heart. Typically, this is because the vessels are damaged, diseased, or blocked by a fatty substance called plaque. A buildup of plaque causes a condition called atherosclerosis, which can cause CAD.

The goals of CAD treatment are to control symptoms and to stop or slow the progression of the disease. Your doctor’s first treatment suggestion for CAD might be lifestyle changes such as improved diet and exercise habits. If these changes alone are not enough, your doctor may prescribe medications. Read on to learn how drugs can help treat CAD and prevent related problems.

A common symptom of CAD is angina, or chest pain. If you have angina, your doctor may prescribe short- or long-acting drugs called nitrates to reduce this pain. Nitroglycerin, a type of nitrate, dilates blood vessels and allows the heart to pump blood with less effort. These actions help relieve chest pain.

Beta blockers are also often prescribed to treat angina. Beta blockers can slow your heart rate and lower your blood pressure. These actions decrease the amount of oxygen your heart needs to work, which can help relieve angina.

Plaque buildup in your blood vessels, a common feature of CAD, can cause blood clots to form. These clots can block your vessels and cause a heart attack.

Blood clots are formed by a buildup of platelets. These red blood cells bind together into a clot to help your body stop bleeding. Certain drugs suppress the activity of platelets, making it harder for blood clots to form within your arteries. This effect reduces your risk of heart attack.

Examples of medications that help keep platelets from forming clots include:

• aspirin
• clopidogrel (Plavix)
• ticlopidine (Ticlid)
• eptifibatide (Integrilin)

High levels of cholesterol in your blood play a key role in causing atherosclerosis. If you have high cholesterol and can’t lower it through a healthy diet and increased physical activity, your doctor may prescribe daily medications.

Examples of drugs that can help reduce your cholesterol levels include:

Bile acid sequestrants

• cholestyramine (Questran)
• colesevelam hydrochloride (WelChol)
• colestipol hydrochloride(Colestid)

Fibrates

• clofibrate (Atromid-S)
• fenofibrate (Tricor)
• gemfibrozil (Lopid)

Statins

• atorvastatin (Lipitor)
• fluvastatin (Lescol)
• lovastatin (Mevacor)
• pravastatin (Pravachol)
• rosuvastatin (Crestor)
• simvastatin (Zocor)

Niacin

• niacin (Niaspan, Nicolar)

Several types of drugs can help lower your blood pressure. These drugs can also help your heart function better in other ways. They include:

Beta blockers

High blood pressure can contribute to CAD because it can damage your blood vessels. Beta blockers help by slowing your heart rate and lowering your blood pressure. These actions also reduce your risk of heart attack, a complication of CAD.

Examples of beta blockers include:

• atenolol (Apo-atenolol)
• carvedilol (Coreg)
• metoprolol (Toprol)
• nadolol (Corgard)
• propranolol (Inderal)
• timolol (Blocadren)

Calcium channel blockers

Calcium channel blockers help increase the amount of oxygen sent to the heart. They relax the vessels of the heart, allowing oxygen-rich blood to flow to it more easily. Calcium channel blockers also lower blood pressure and relax other blood vessels in the body. These effects can decrease the amount of oxygen the heart needs.

Examples of calcium channel blockers include:

• amlodipine (Norvasc)
• felodipine (Plendil)
• isradipine (DynaCirc)
• nicardipine (Cardene)
• nifedipine (Adalat, Procardia)
• diltiazem (Cardizem)

ACE inhibitors and ARBs

Angiotensin II is a hormone in your body that constricts your blood vessels. Tightening blood vessels raise your blood pressure and increase the amount of oxygen your heart needs.

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) reduce the effects of angiotensin II. They work to prevent increases in blood pressure. These types of medications can lower your risk of stroke or heart attack.

Examples of ACE inhibitors include:

• benazepril (Lotensin)
• captopril (Capoten)
• enalapril (Vasotec)
• fosinopril (Monopril)
• lisinopril (Prinivil, Zestril)
• moexipril (Univasc)
• perindopril (Aceon)
• quinapril (Accupril)
• ramipril (Altace)
• trandolapril (Mavik)

Examples of ARBs include:

• irbesartan (Avapro)
• losartan (Cozaar)
• telmisartan (Micardis)
• valsartan (Diovan)

Medications used to treat CAD can:

• lower your cholesterol levels
• lower your blood pressure
• reduce your heart’s workload
• prevent blood clots
• increase the amount of oxygen sent to your heart

All of these actions can help reduce your CAD symptoms and prevent serious complications such as heart attack or stroke.

Your doctor can tell you more about drugs that can help your CAD. Questions you might ask them include:

• What drugs are best suited for my symptoms and medical history?
• Am I taking any other medications that might interact with a CAD drug?
• Are there non-drug ways I can reduce my CAD symptoms?