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Drug Treatments There are a wide variety of modern drug treatments for heart disease Angiotensin converting enzyme (ACE) inhibitors such as ramipril and lisinopril control high blood pressure

and help protect the heart. Angiotensin II receptor antagonists or blockers (ARBs) also lower blood pressure. Some research now suggests this type of drug may have fewer side-effects than ACE inhibitors, but this is still under review. Anti-arrhythmic drugs help to control problems with the heart\'s rhythm. They include amiodarone, flecainide (mainly used for serious pacemaker problems), propafenone and the \'old-fashioned\' drug digoxin, which is still the usual treatment for atrial fibrillation. Aspirin and antiplatelet drugs such as Clopidrogel help reduce the ‘stickiness’ of blood and so prevent blood clotting in the arteries. Beta-blockers are commonly prescribed in the treatment of angina, high blood pressure and heart failure. They allow the heart to slow down and not work so hard. These are sometimes used in conjunction with diuretics or \'water tablets\' to control blood pressure or remove excess fluid from the body. Calcium channel blockers reduce the amount of calcium entering the muscle cells of the arteries, causing them to relax. This increases blood flow to the heart and reduces the work the heart has to do to pump blood around the body. Examples include nifedipine and diltiazem. Nitrates dilate the coronary arteries and so improve blood flow to the heart muscle, which helps to relieve angina. Taken as a tablet under the tongue or as a fast-acting spray, they are useful for relieving angina pain and preventing predictable attacks. They can also be given in a slower-acting tablet form or as a patch on the skin. Statins are used to help lower cholesterol levels in the blood. High cholestrol is a major risk factor for heart disease. Statins can reduce the risk of dying of coronary heart disease by around 25 per cent. Examples are simvastatin, atorvastatin and rosuvastatin. Cholesterol-lowering drugs: if statins cause side-effects,other forms of cholesterol-lowering drugs are available, such as fibrates, drugs that bind bile acids (eg colysteramine) and drugs that inhibit the intestinal absorption of cholesterol, such as ezetimibe. Thrombolytic drugs dissolve the blood clots that trigger a heart attack. If given within an hour of a heart attack, they can open up blood flow through the affected artery, avoiding permanent damage to heart muscle. These \'clot-busters\' have dramatically improved the treatment and survival rates of heart attacks.




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