Reducing Risk of Another Heart Attack With Medicine: Care Instructions

Your Care Instructions

After a heart attack, medicines help lower your risk of having another one. These medicines include:

• ACE inhibitors or ARBs. These are types of blood pressure medicines.
• Statins and other cholesterol medicines. These lower cholesterol.
• Aspirin and other antiplatelets. These medicines prevent blood clots from forming in your blood vessels. This can help prevent a heart attack.
• Beta-blocker medicines. These are a type of blood pressure and heart medicine.

All medicines can cause side effects. So it is important to understand the pros and cons of any medicine you take. It is also important to take your medicines exactly as your doctor tells you to.

ACE inhibitors

ACE (angiotensin-converting enzyme) inhibitors are used for three main reasons. They lower blood pressure. They protect the kidneys. And they prevent heart attacks and strokes. Examples include:

• Benazepril (Lotensin).
• Lisinopril (Prinivil).
• Ramipril (Altace).

An angiotensin II receptor blocker (ARB) may be used instead of an ACE inhibitor. ARBs help you in the same ways as ACE inhibitors. Examples include:

• Candesartan (Atacand).
• Irbesartan (Avapro).
• Losartan (Cozaar).

Before you start taking an ACE inhibitor or an ARB, make sure your doctor knows if you:

• Take water pills (diuretics).
• Take potassium pills or use salt substitutes.
• Are pregnant or breastfeeding.
• Had a kidney transplant or other kidney problems.

ACE inhibitors and ARBs can cause side effects. Call your doctor right away if you have:

• Trouble breathing.
• Swelling in your face, head, neck, or tongue.

Statins

Statins can help lower your risk for a heart attack and stroke. This medicine lowers your cholesterol. Examples include:

• Atorvastatin (Lipitor).
• Pravastatin (Pravachol).
• Simvastatin (Zocor).

Before you start taking a statin, talk to your doctor. Make sure your doctor knows if:

• You have had a kidney transplant or other kidney problems.
• You have liver disease.
• You take any other prescription medicine, over-the-counter medicine, vitamins, supplements, or herbal remedies.
• You are pregnant or breastfeeding.

Statins can cause side effects. Call your doctor if you have side effects that bother you. There may be different statins you can try. Work with your doctor to find the right statin and amount for you.

Aspirin

After a heart attack, aspirin can help lower your risk of having another one. Most heart attacks are caused by a blood clot that blocks a coronary artery. When this happens, oxygen can't get to the heart muscle, and part of the heart dies. Aspirin can help prevent blood clots that can block the blood vessels.

You may not be able to use aspirin if you:

• Have asthma or certain other health conditions.
• Have an ulcer or other stomach problem.
• Take some other medicine (called a blood thinner) that prevents blood clots.
• Are allergic to aspirin.

Your doctor may recommend that you take one low-dose aspirin (81 mg) tablet each day, with a meal and a full glass of water.

Aspirin can also cause serious bleeding. Be sure you get instructions about how to take aspirin safely.

Call your doctor right away if you have:

• Unusual bleeding.
• Nausea, vomiting, or heartburn.
• Black or bloody stools.

Beta-blockers

Beta-blockers are used for three main reasons. They lower blood pressure. They relieve angina symptoms (such as chest pain or pressure). And they may reduce the chances of a second heart attack. They include:

• Atenolol (Tenormin).
• Carvedilol (Coreg).
• Metoprolol (Lopressor).

Before you start taking a beta-blocker, make sure your doctor knows if you have:

• Severe asthma or frequent asthma attacks.
• A very slow pulse. (This is less than 55 beats a minute.)

Beta-blockers can cause side effects. Call your doctor if you:

• Wheeze or have trouble breathing.
• Feel dizzy or lightheaded.
• Have asthma that gets worse.