Heart Medications Archive

Articles

Medication vs. stents for heart disease treatment

ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. 

What's the best way to "fix" a narrowed coronary artery? That question was the crux of a multimillion-dollar trial dubbed COURAGE, short for Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation. Its results, presented in the spring of 2007, stunned some doctors and seemed to shock the media, but we hope they won't come as a surprise to readers: For people with stable coronary artery disease (clogged arteries nourishing the heart), artery-opening angioplasty was no better than medications and lifestyle changes at preventing future heart attacks or strokes, nor did it extend life.

Aspirin for heart attack: Chew or swallow?

Immediate first aid works to minimize blood clotting triggered by plaque ruptures

How should you take aspirin for a heart attack? You've always been healthy, but you seemed to run out of steam at your wife's 60th birthday dinner last week. And now your chest feels heavy, as if you're in a vise. You take some antacids, even though it's 7:00 a.m. and you haven't even had breakfast. But you get no relief, and the pain is spreading to your jaw and shoulder. You call your wife, who takes one look at you and rushes to the phone. After calling 911, she brings you an aspirin and some water.

Your wife got it right: You may be having a heart attack, and you need to get to the hospital fast. You also need to get some aspirin into your system quickly — but should you chew the tablet or swallow it?

Using Crestor — and all statins — safely

Some simple steps can help minimize or avoid muscle problems from Crestor and other cholesterol-lowering drugs.

All drugs have side effects. The trick is to weigh the potential for serious side effects against the gain you can get from the medication. The balance sheet for Crestor and other statins looks like this: These drugs cut the risk of heart attack, angina (chest pain), stroke, and death from cardiovascular disease by 30%. They cause muscle pain in under 5% of the people who take them, and these pains often stop by themselves even with continued statin use. The chance of rhabdomyolysis, a potentially deadly breakdown of muscle tissue, is less than one per million statin prescriptions.

Statins may offer a long-term legacy benefit

Cholesterol-lowering statins seem to have long-lasting benefits against heart disease, according to a 20-year follow-up of a landmark Scottish study.

In the original study, published in 1995, more than 6,500 middle-aged men with high levels of harmful LDL cholesterol took either 40 milligrams of pravastatin (Pravachol) or a placebo daily for an average of nearly five years. For the follow-up, published in the March 15 Circulation, researchers used electronic medical records to analyze health-related events among the same men over the following two decades. They also tracked the men's use of statins after the original study ended. After five years, more than a third of the men in both groups were taking statins, but no further data on statin use was available after that.

FDA withdraws approval for two older cholesterol drugs

The FDA has withdrawn its approval for two older cholesterol-lowering medications, niacin and fenofibrate, for use in combination with a statin. Several large clinical trials found no heart-related benefits from the drugs. 

Drug interactions with statins: Often preventable

Statins can lower heart disease risk dramatically, but certain cautions apply.

Nearly a quarter of all adults over age 40 take medication to treat high cholesterol, and most often, it’s a statin drug. However, with such widespread use, especially among people who may have other cardiovascular risk factors, an un-wanted interaction between a statin and another medication can occur. For this reason, the American Heart Association recently issued a statement to help doctors better navigate medication choices for their patients.

What is a drug interaction?

The term “drug interaction” is somewhat misleading. Typically, drugs do not chemically react with each other in the body. Instead, a drug, supplement, or food may affect how long a medication stays in the body, often by stimulating or inhibiting the production of specific enzymes in the liver or intestine (see “The truth about grapefruit juice”).

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