Heart Medications Archive


Are some painkillers safer for your heart than others?

Despite new research, the answer is unclear. Use caution when taking any pain medication on a routine basis.

Image: iStock

People with aching joints from arthritis—which affects nearly one in four adults—often rely on drugs known as NSAIDs to ease the pain of this often-debilitating condition. These popular medications also relieve headaches, cool fevers, and dampen inflammation. But with the exception of aspirin, most NSAIDs pose a risk to the cardiovascular system, notes Harvard professor Dr. Elliott Antman, a cardiologist at Brigham and Women's Hospital.

"Taking NSAIDs routinely over a long time period can raise the risk of blood clots, increase blood pressure, and accelerate cardiovascular disease," says Dr. Antman. While the danger is greatest in people with heart disease, it's also present in people without any signs of the disease.

Does aspirin stop a heart attack?

Ask the doctor

Q. Should I take aspirin if I think I'm having a heart attack, and what kind of aspirin should I take?

A. First, what symptoms indicate you might be having a heart attack? The main symptom is a squeezing, tight sensation in the middle of the chest that can travel up into the jaw and shoulders, and even down the left arm. Along with the pain you may begin to sweat and to feel weak, like you might pass out, and be short of breath. While other conditions besides a heart at-tack can cause similar symptoms, you need to take such symptoms very seriously. First, call 911.

Is my medication causing these side effects, or is it just aging?

Tracking your progress and symptoms can help you discern the difference.

Image: YakobchukOlena/Thinkstock

You probably know that when you take a medication, you need to tell your doctor about any side effects that develop. But being aware of side effects can be challenging when you're older. "In many cases, the signs of aging are similar to side effects of medications," says Joanne Doyle Petrongolo, a pharmacist at Harvard-affiliated Massachusetts General Hospital.


What you should do

To determine if your symptoms are drug side effects or signs of aging, Doyle Petrongolo recommends keeping good records of your health issues and medication changes. "Keep a chart or a log of all medications taken, and record the medication start date. If a side effect is noted within a few days or weeks of starting a medication, then it is more likely that the symptom is medication-related," she explains.

It may be weeks or months before a symptom develops, but don't wait too long to report a symptom, especially if it interferes with your daily activity. "If it lingers for several weeks, then it is a good idea to speak with a doctor or pharmacist to determine the cause," says Doyle Petrongolo.

The fix

Does it matter how you lower your cholesterol?

Certain cholesterol-lowering medications—namely, ezetimibe (Zetia) and drugs known as bile acid binders—also appear to be effective at lowering cholesterol and reducing the risk of serious cardiovascular events. 

Drugs to prevent heart attacks may also lessen their severity

Medications such as aspirin, statins, ACE inhibitors, and beta blockers are prescribed to certain patients to lower the chance of a first or repeat heart attack. New research shows that they also may reduce the severity of attacks that do occur.

Reminder: Don't skip blood pressure medication

Millions of older adults aren’t taking their blood pressure drugs as directed. Ways to combat adherence problems include asking a doctor for less expensive drugs, understanding what a medication is for, and reporting side effects. 

Gene discoveries may pave the way for new blood pressure drugs

The discovery of 44 gene sites associated with high blood pressure may provide leads for developing new drugs to treat this common condition. 

Making sense of the statin guidelines

Image: rogerashford/ iStock

For years, doctors prescribed cholesterol-lowing statins based largely on cholesterol test results. The goal was to lower total cholesterol to under 200 mg/dL, and LDL (bad) cholesterol to under 100 mg/dL. But in late 2013, new guidelines on statin use issued by the American Heart Association (AHA) and the American College of Cardiology (ACC) proposed a major change to that strategy.

These guidelines shifted from a numbers-based approach to a risk-driven approach. Instead of aiming for a specific cholesterol value, doctors were urged to look at a person's entire cardiovascular risk profile when considering treatment. This is a reasonable approach that can help better define when to initiate drug therapy.

Preventing blood clots: Is warfarin still right for you?

Using warfarin effectively is challenging—perhaps even more so than doctors have realized.

 Image: arun011 /Thinkstock

For more than 60 years, warfarin has been a mainstay for people with atrial fibrillation. Used properly, warfarin may prevent as many as 60% of strokes related to this common heart rhythm disorder each year. But warfarin is notoriously tricky to manage because blood levels have to be kept within a narrow range to avoid side effects such as unwanted bleeding.

As a result, warfarin users must get frequent blood tests (see "What is an INR?") when they start the drug to fine-tune their dose. Once their INR values are consistently in the right range, most people scale back to testing every month or so. But a recent study suggests that people who take warfarin need to stay extra vigilant over the long term.

Many older adults take unneeded blood pressure drugs

About 66% of adults over age 70 still take antihypertensive medication even though they now have low pressures, says a study from the University of Kent in the United Kingdom. Researchers say this exposes adults to medication side effects like dizziness and falls. 

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