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Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

If you have had a heart attack, your healthcare provider has probably prescribed medicines that you will need to take for a long time. These medicines:

• help improve blood flow to your heart,
• prevent blood clotting,
• reduce your risk of having more heart problems in the future.

Path to improved health

Below is information about medicines that are commonly prescribed to treat heart attack. This includes their benefits, risks, and side effects. If you have questions or concerns about the medicines you’re taking, talk to your healthcare provider.

ACE Inhibitors

ACE inhibitors can improve how your heart pumps making it pump more effectively. This type of medicine improves blood flow by helping to open (dilate) your arteries and lower your blood pressure.

If you have acute coronary syndrome ACS, your healthcare provider may want you to take an ACE inhibitor. Having ACS means that you have reduced blood flow to the heart. It could be caused by a variety of conditions. One ACE inhibitor might be all the medicine you need. Or your healthcare provider may prescribe one in combination with other medicines. These could include a diuretic or a beta blocker.

Side effects. ACE inhibitors don’t usually cause troublesome side effects. The most common side effect is a dry cough. More rare side effects include:

• Dizziness,
• Reduced appetite,
• Fatigue (feeling out of energy),
• Problems with the kidneys
• An increase in the level of potassium in the blood.

Risks. Because ACE inhibitors can cause birth defects, pregnant women should not take this type of medicine.

In rare cases, ACE inhibitors can lead to a serious allergic reaction (called an anaphylactic reaction) that causes swelling in certain areas of the body. This reaction is more common in people of African descent and people who smoke. It can be life-threatening. You should get immediate medical attention if you experience swelling after taking an ACE inhibitor.

Aspirin

Your healthcare provider may want you to take a low dose of aspirin each day. Aspirin helps keep your blood from forming clots. Blood clots can clog the arteries that carry blood and oxygen to the heart (called the coronary arteries). Blockages in the coronary arteries increase your risk of having a heart attack or stroke.

Side effects. Common side effects of aspirin include nausea and upset stomach. Some people feel nervous or have difficulty falling asleep when taking aspirin. Contact your healthcare provider if your symptoms are bothersome.

Risks. Aspirin can increase your risk of stomach ulcers and gastrointestinal bleeding (bleeding in your stomach and intestines). Healthcare providers usually prescribe a low dose of aspirin (between 81 mg per day and 162 mg per day) for people who have ACS. The low dose provides the same benefits as a higher dose, with less risk of internal bleeding.

Contact your healthcare provider about the risks and benefits of aspirin therapy. Your healthcare provider will prescribe the aspirin dose that is right for you and tell you exactly how to take it.

Beta Blockers

Beta blockers lower the heart rate and blood pressure. They also help improve blood flow to the heart, reduce chest pain and prevent more damage to the heart.

Your healthcare provider may want you to take a beta blocker alone or in combination with other medicines. These could include a diuretic or an ACE inhibitor.

Side effects. The side effects of beta blockers tend to be mild. Common side effects include cold hands, fatigue, dizziness and weakness. Less common side effects include shortness of breath, difficulty sleeping, depression and decreased sex drive.

Risks. Beta blockers are not recommended for people who have asthma. This type of medicine can trigger severe asthma attacks.

Beta blockers may make it difficult for people with diabetes to recognize signs of low blood sugar. One of these signs is a  rapid heartbeat. If you have diabetes, your healthcare provider will probably tell you to check your blood sugar often.

Stopping beta blockers abruptly increases the risk of heart problems. If you need to stop taking a beta blocker, it’s important to stop gradually. Follow your healthcare provider’s instructions carefully.

Antiplatelet Drugs

Antiplatelet medicines help prevent blood clots. They don’t allow certain cells in the blood (called platelets) to clump together. This reduces the risk of blockages in the coronary arteries that can lead to heart attack and stroke. They’re sometimes prescribed along with aspirin therapy.

Side effects. Some common side effects of antiplatelet drugs include:

• Nausea,
• Upset stomach,
• Stomach pain,
• Diarrhea,
• Itching
• Rash.

Contact your healthcare provider if you experience side effects while taking this medicine.

Risks. Because antiplatelet drugs prevent blood clotting, they can increase the risk of serious bleeding in some people.

Diuretics

Diuretics (water pills) help the body get rid of extra sodium (salt) and fluid. They reduce the amount of fluid flowing through your blood vessels. This lowers your blood pressure. Diuretics are very commonly prescribed to treat high blood pressure. They are sometimes used in combination with beta blockers and ACE inhibitors.

Side effects. Common side effects of diuretics include:

• Increased urination,
• Increased thirst,
• Fatigue,
• Muscle cramps
• Low blood pressure.

Less common side effects include increased blood sugar, increased cholesterol, irregular menstrual periods, and impotence in men.

Risks. People who take diuretics can have too much or too little potassium in their blood, depending on the type of diuretic they take.

Statins

Statins are used to lower “bad” cholesterol (also called LDL, or low-density lipoprotein) levels.  Most people who take statins will take this type of medicine for the rest of their lives.

Side effects. Muscle pain is the most common side effect of statins. The pain can be mild or severe. Less common side effects include nausea, diarrhea, gas and constipation. People who take statins may also get a rash. This side effect is more common when a statin is taken in combination with niacin. This is another medicine used to lower cholesterol levels.

You are at higher risk of having side effects from statins if you:

• Are a woman.
• Are age 65 or older.
• Have liver or kidney disease.
• Have type 1 or type 2 diabetes.
• Take several types of medicine.

Some people may feel discouraged by the side effects caused by statins. However, the side effects are not usually life-threatening. Your healthcare provider can help you find ways to manage them. If you are worried about side effects, contact your healthcare provider about the risks and benefits of taking statins.

Risks. In some people, statins can cause liver damage.

Anticoagulants (blood thinners)

Blood thinners don’t actually thin the blood. They decrease the ability of the blood to clot. This helps prevent clots from forming in the blood vessels. It also may prevent clots from becoming larger. Large clots can cause more serious problems.

Side Effects: The most significant side effect of blood thinners is bleeding. Your blood doesn’t clot as easily. If you cut or injure yourself, you’ll bleed more than normal. The risk of bleeding being a major event is low.

Blood thinners can cause interactions. These could be with some foods, prescription medicines, or over-the-counter supplements. Less serious side effects include:

• Swelling at the injection site
• Diarrhea, vomiting, or inability to eat
• Fever
• Heavier than normal menstrual periods or bleeding between periods

Risks: Some people who take blood thinners are more at risk of having bleeding problems. These include people who:

• Are older than 75
• Take other blood-thinning medicines
• Have high blood pressure
• Have cancer
• Have problems with their kidneys or liver

Be sure to tell your healthcare provider about any other medicines or supplements you take. Tell other health care providers that you are taking a blood thinner.

Things to consider

All medicines can cause side effects. They also can carry risks for certain people. Always tell your healthcare provider about any medicines you take. Tell them about any side effects you’re experiencing. Make sure they know your full medical history so they can prescribe the best medicine for you.

FOR MORE INFORMATION

Heart and Stroke Foundation of Canada

Toll free 1-888-473-4636

http://www.heartandstroke.ca/