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Heart Disease - Glossary Of Cardiac Medication

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Angiotensin-converting enzyme (ACE) inhibitors improve survival with congestive heart failure and ischemic heart disease, reduce complications and incidence of diabetes, and lower blood pressure. They may decrease kidney function, increase potassium levels, and cause a dry cough. Also present the rare risk of angioedema. Angiotensin receptor blockers are useful to lower blood pressure and for congestive heart failure with no cough. However, they may cause renal failure or elevated potassium levels.

Aspirin is a blood thinner that reduces death from heart attacks and angina and reduces the chance of strokes. It does present a very small increased risk of bleeding and ulcer irritation may occur.

Beta blockers improve survival following heart attacks with congestive heart failure and with hypertension, lower blood pressure, have antiarrhythmic benefits, and also improve heart function. Side effects include possible fatigue, depression, erectile dysfunction, and bradycardia. Beta blockers are contraindicated in asthmatics. Calcium channel blockers are used to reduce blood pressure and help with angina. May be associated with constipation or reflux. Constipation may be a bigger problem with older patients, especially if immobility is present. Edema is another possible problem associated with these drugs.

Clopedigrol is a blood thinner used to reduce heart attack or stroke and may be used with or instead of aspirin.

Digoxin is used in the treatment of heart failure and reduces symptoms and hospitalizations. Adverse effects include nausea, GI upset, and bradycardia.

Diuretics are useful for lowering blood pressure and treating symptoms of congestive heart failure. May be associated with postural hypotension. Also can cause electrolyte abnormalities, including low potassium. May increase uric acid and precipitate gouty attacks.

Nitroglycerin is used to treat symptoms of angina. It may cause headaches, but tolerance develops.

Spironolactone is used to treat severe congestive heart failure, but may increase potassium and decrease renal function. It also may cause gynecomastia and increased hair growth.

Statins (HMG-CoA reductase inhibitors) are useful in reducing cholesterol and decreasing the risk of heart attacks and strokes. Very rare problems with liver abnormalities or muscle pain sometimes occur.

Warfarin is used to prevent strokes with valvular heart disease and with atrial fibrillation. Negative effects include the increased risk of bleeding.



ACE Inhibitor Myocardial Infarction Collaborative Group. "Indications for ACE Inhibitors in the Early Treatment of Acute Myocardial Infarction." Circulation 97 (1998): 2202–2212.

ALLHAT Collaborative Research Group. "Major Cardiovascular Events in Hypertensive Patients Randomized to Doxazosin vs. Chlorthalidone." Journal of the American Medical Association 283, no. 15 (2000): 1967–1975.

Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators. "A Comparison of Antiarrhythmic-Drug Therapy With Implantable Defibrillators in Patients Resuscitated From Near-Fatal Ventricular Arrhythmias." New England Journal of Medicine 337 (1997): 1576–1583.

ANTMAN, E. M.; COHEN, M.; RADLEY, D.; et al. "Assessment of the Treatment Effect of Enoxaparin for Unstable Angina/Non-Q-Wave Myocardial Infarction." Circulation 100 (1999): 1602–1608.

Atrial Fibrillation Investigators. "Risk Factors for Stroke and Efficacy of Antithrombotic Therapy in Atrial Fibrillation." Archives of Internal Medicine 154 (1994): 1449–1457.

BONOW, R. O.; CARABELLO, B.; DE LEON, A. C. JR.; et al. "ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease." Journal of the American College of Cardiology 32 (1998): 1486–1588.

CANTO, J. G.; SHLIPAK, M. G.; ROGERS, W. J.; et al. "Prevalence, Clinical Characteristics, and Mortality Among Patients With Myocardial Infarction Presenting Without Chest Pain." Journal of the American Medical Association 283 (2000): 3223–3229.

Cardiac Arrhythmia Suppression Trial (CAST) Investigators. "Effect of Encainide and Flecainide on Mortality in a Randomized Trial of Arrhythmia Suppression After Myocardial Infarction." New England Journal of Medicine 321 (1989): 406–412.

CIBIS-II Investigators and Committees. "The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): A Randomised Trial." Lancet 353 (1999): 9–13.

COHEN, M.; DEMERS, C.; GURFINKEL, E. P.; et al. "A Comparison of Low-Molecular-Weight Heparin With Unfractionated Heparin For Unstable Coronary Artery Disease." New England Journal of Medicine 337 (1997): 447–452.

CURB, J. D.; PRESSEL, S. L.; CUTLER, J. A.; et al. "Effect of Diuretic-Based Antihypertensive Treatment on Cardiovascular Disease Risk in Older Diabetic Patients With Isolated Systolic Hypertension." Journal of the American Medical Association 276 (1996): 1886–1892.

DAJANI, A. S.; TAUBERT, K. A.; WILSON, W.; et al. "Prevention of Bacterial Endocarditis." Circulation 96 (1997): 358–366.

DE LORGERIL, M., et al. "Mediterranean Alpha-Linolenic Acid-Rich Diet in Secondary Prevention of Coronary Heart Disease." Lancet 343 (1994): 1454–1460.

DE LORGERIL, M.; SALEN, P.; MARTIN, J.; et al. "Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications after Myocardial Infarction." Circulation 99 (1999): 779–785.

Digitalis Investigation Group. "The Effect of Digoxin on Mortality and Morbidity in Patients With Heart Failure." New England Journal of Medicine 336 (1997): 525–533.

DOWNS, J. R.; CLEARFIELD, M.; WEIS, S.; et al. "Primary Prevention of Acute Coronary Events with Lovastatin in Men and Women with Average Cholesterol Levels." Journal of the American Medical Association 279 (1998): 1615–1622.

GIBBONS, R. J.; CHATTERJEE, K.; DALEY, J.; et al. "ACC/AHA/ACP-ASIM Guidelines for the Management of Patients with Chronic Stable Angina: Executive Summary and Recommendations." Circulation 99 (1999): 2829–2848.

GILL, T. M.; DIPIETRO, L.; and KRUMHOLZ, H. M. "Role of Exercise Stress Testing and Safety Monitoring for Older Persons Starting an Exercise Program." Journal of the American Medical Association 284 (2000): 342–349.

GISSI-Prevenzione Investigators. "Dietary Supplementation with N-3 Polyunsaturated Fatty Acids and Vitamin E after Myocardial Infarction: Results of the GISSI-Prevenzione Trial." Lancet 354 (1999): 447–455.

HAKIM, A. A.; CURB, J. D.; PETROVITCH, H.; et al. "Effects of Walking on Coronary Heart Disease in Elderly Men." Circulation 100 (1999): 9–13.

HANSSON, L.; LINDHOLM, L. H.; EKBOM, T.; et al. "Randomised Trial of Old and New Anti-hypertensive Drugs in Elderly Patients: Cardiovascular Mortality and Morbidity the Swedish Trial in Old Patients with Hypertension-2 Study." Lancet 354 (1999): 1751–1756.

HAYES, D. L.; WANG, P. J.; REYNOLDS, D. W.; et al. "Interference with Cardiac Pacemakers by Cellular Telephones." New England Journal of Medicine 336 (1997): 1473–1479.

Heart Outcomes Prevention Evaluation Study Investigators. "Effects of an Angiotensin-Converting-Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Patients." New England Journal of Medicine 342 (2000): 145–153.

HJALMARSON, A.; GOLDSTEIN, S.; FAGERBERG, B.; et al. "Effects of Controlled-Release Metoprolol on Total Mortality, Hospitalizations, and Well-Being in Patients with Heart Failure." Journal of the American Medical Association 283 (2000): 1295–1302.

HULLEY, S.; GRADY, D.; BUSH, T.; et al. "Randomized Trial of Estrogen Plus Progestin for Secondary Prevention of Coronary Heart Disease in Postmenopausal Women." Journal of the American Medical Association 280, no. 7 (1998): 605–613.

ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. "Randomised Trial of Intravenous Streptokinase, Oral Aspirin, Both, or Neither Among 17,187 Cases of Suspected Acute Myocardial Infarction: ISIS-2." Lancet (1988): 349–360.

JORENBY, D. E.; LEISCHOW, S. J.; NIDES, M. A.; et al. "A Controlled Trial of Sustained-Release Bupropion, a Nicotine Patch, or Both for Smoking Cessation." New England Journal of Medicine 340, no. 9 (1999): 685–691.

KIRKLIN, J. K.; NAFTEL, D. C.; BLACKSTONE, E. H.; et al. "Risk Factors for Mortality After Primary Combined Valvular and Coronary Artery Surgery." Circulation 79, suppl. 1 (1989): 185–190.

LOGEAIS, Y.; LANGANAY, T.; ROUSSIN, R.; et al. "Surgery for Aortic Stenosis in Elderly Patients." Circulation 90 (1994): 2891–2898.

Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. "Prevention of Cardiovascular Events and Death with Pravastatin in Patients with Coronary Heart Disease and a Broad Range of Initial Cholesterol Levels." New England Journal of Medicine 339 (1998): 1349–1357.

Medical Research Council Working Party. "Medical Research Council Trial of Treatment of Hypertension in Older Adults: Principal Results." British Medical Journal 304 (1992): 405–412.

PAUL, S. D.; O'GARA, P. T.; MAHJOUB, Z. A.; et al. "Geriatric Patients with Acute Myocardial Infarction: Cardiac Risk Factor Profiles, Presentation, Thrombolysis, Coronary Interventions, and Prognosis." American Heart Journal 131 (1996): 710–715.

PITT, B.; POOLE-WILSON, P. A.; SEGAL, R.; et al. "Effect of Losartan Compared with Captopril on Mortality in Patients with Symptomatic Heart Failure: Randomised Trial—The Losartan Heart Failure Survival Study ELITE II." Lancet 355 (2000): 1582–1587.

PITT, B.; ZANNAD, F.; REMME, W. J.; et al. "The Effect of Spironolactone on Morbidity and Mortality in Patients with Severe Heart Failure." New England Journal of Medicine 341 (1999): 709–717.

RYAN, T. J.; ANTMAN, E. M.; BROOKS, N. H.; et al. "ACC/AHA Guidelines for the Management of Patients with Acute Myocardial Infarction." Journal of the American College of Cardiology 34 (1999): 890–911.

SACKS, F. M.; PFEFFER, M. A.; MOYE, L. A.; et al. "The Effect of Pravastatin on Coronary Events after Myocardial Infarction in Patients with Average Cholesterol Levels." New England Journal of Medicine 335 (1996): 1001–1009.

SCHLANT, R. C., and ALEXANDER, R. W. Hurst's the Heart, 8th ed. New York: McGraw-Hill, 1994. SHAPIRA, O. M.; KELLEHER, R. M.; ZELINGHER, J.; et al. "Prognosis and Quality of Life after Valve Surgery in Patients Older than 75 Years." Chest 112 (1997): 885–894.

SHEPHERD, J.; COBBE, S. M.; FORD, I.; et al. "Prevention of Coronary Heart Disease with Pravastatin in Men with Hypercholesterolemia." New England Journal of Medicine 333 (1995): 1301–1307.

SOLVD Investigators. "Effect of Enalapril on Survival in Patients with Reduced Left Ventricular Ejection Fractions and Congestive Heart Failure." New England Journal of Medicine 325 (1991): 293–302.

SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators. "Patients with Nonvalvular Atrial Fibrillation at Low Risk of Stroke During Treatment with Aspirin." Journal of the American Medical Association 279 (1998): 1273–1277.

STAESSEN, J. A.; FAGARD, R.; THIJS, L.; et al. "Randomised Double-Blind Comparison of Placebo and Active Treatment for Older Patients with Isolated Systolic Hypertension." Lancet 350 (1997): 757–764.

Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. "A Clinical Practice Guideline for Treating Tobacco Use and Dependence." Journal of the American Medical Association 283 (2000): 3244–3254.

U.K. Prospective Diabetes Study Group. "Tight Blood Pressure Control and Risk of Macrovascular and Microvascular Complications in Type 2 Diabetes: UKPDS 38." British Medical Journal 317 (1998): 703–713.

YUSUS, S. Evidence Based Cardiology, 1st ed. London: British Medical Journal Publications, 1998.

ZIJLSTRA, F.; HOORNTJE, J. C. A.; DE BOER, M.; et al. "Long-Term Benefit of Primary Angioplasty as Compared with Thrombolytic Therapy for Acute Myocardial Infarction." New England Journal of Medicine 341 (1999): 1413–1419.

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