8. Treating heart conditions with medications and lifestyle alternatives to drugs!

Reminder: Cardiovascular disease (CVD) is the scientific medical term for all types of disease that affect the heart or blood vessels.  CVD includes coronary heart disease (clogged up arteries with fatty deposits), which can cause heart attacks, stroke, heart failure, and peripheral artery disease.

Cholesterol and the use of statins

Cholesterol is an important lipid that is essential for the functioning of your body.

BUT, there are two types of cholesterol:

(i) Too much of LDL cholesterol ('bad cholesterol') can cause health issues.

Too much LDL cholesterol in your bloodstream contributes to fatty deposits on the inner walls of the arteries, restricting blood flow, causing coronary hear disease (see diagram in stents section).

(ii) 'Good cholesterol', known as HDL cholesterol, helps remove other forms of cholesterol from your bloodstream.

The ratio of LDL to HDL seems to be an important factor to have healthy levels of the different types of cholesterol.

Statins are drugs used to treat to high a level of bad cholesterol

Statins slow down the rate at which fatty deposits are formed on artery walls.

For some patients, they are now considered as life-long medication.

Advantages of statins

(i) Statins have been clinically proven to reduce the level of 'bad cholesterol' (LDL cholesterol) in the bloodstream. This in turns slows down the rate at which fat is deposited on the walls of the arteries. This reduces the risk of strokes, heart attacks and suffering from angina and coronary heart disease and.

Angina is chest pain caused by reduced blood flow to the heart muscles.

(ii) Statins can increase the amount of 'good cholesterol' (HDL cholesterol) in the bloodstream as well as reducing the level of 'bad cholesterol' (LDL cholesterol) - all helping the benefits described above.

(iii) There has been some evidence that statins may prevent other diseases.

I can't find out anything about (iii), but research references to Alzheimer's disease and motor neurone disease

Disadvantages of statins

(i) There are adverse side effects from taking statins e.g. headaches,  diarrhoea and aching muscle fatigue and damage. In extreme cases you can suffer kidney failure, liver damage and memory loss.

(ii) The artery can age and narrow over time because stints can cause irritation and make scar tissue grow, therefore a CVD patient may have to take extra medication to stop blood clots forming on the stent.

(iii) Statins are a drug that must be taken regularly over a long period of time and the patient should ensure they don't forget to take their medication.

(iv) It takes some time for statins to take effect in reducing your cholesterol level, you need to be a patient-patient!

 

Other drugs used to treat cardiovascular disease conditions

Aspirin

Aspirin is used as a painkiller and anti-inflammatory drug, but it is also a useful prescribed medication for treating cardiovascular disease problems e.g.

A daily, low dose of aspirin is prescribed for people suffering from cardiovascular disease, such as peripheral arterial disease, or who have had a heart attack or certain types of stroke.

It reduces the risk of blood clots forming (referred to as 'thinning the blood') - the aspirin can inhibit the action of circulating blood cells known as platelets - it reduces their action to stick together.

However, healthy people should not take aspirin because of side-effects e.g. it can cause bleeding in the stomach or intestines.
 

Anticoagulants - advantages and disadvantages

Anticoagulant drugs like Warfarin are prescribed to reduce the risk of blood clots forming with patients suffering from cardiovascular disease.

Anticoagulants allow the blood to flow more freely to vital organs and reduce the risks of heart attacks and strokes.

BUT, a disadvantage, there is a risk of excessive bleeding if you cut yourself in an accident.

If the wound is severe, there is the danger of losing a significant amount of blood leading to a life threatening situation. There is also a danger, that the injury, combined with taking an anticoagulant, that internal bleeding occurs.

Antihypertensives - advantages and disadvantages

Antihypertensives are medications prescribed to reduce blood pressure. They help prevent damage to blood vessel due to excess higher blood pressure and reduce the risk of excessive fatty deposits forming on the arteries.

There are different types of antihypertensives, that help reduce blood pressure in different ways e.g.

ACE inhibitors relax the blood vessels to ease blood flow.

Beta blockers cause the heart to beat more slowly and less forcefully.

Diuretics help remove excess water.

However, they can have side effects - dizziness, fainting, headaches, feeling sick - looking at the information on my own blood pressure tablets, there is quite a long list of possible side-effects !!

 

Alternatives to statins and other CVD medications - lifestyle 'action'

You can make lifestyle changes to reduce your risk of developing cardiovascular disease (CVD) AND such changes would be advised as part of your treatment if you already suffer from CVD - to reduce the risk of further heart attacks or strokes.

Lifestyle changes that can reduce your cholesterol level and  cardiovascular disease risk include:

Eating a healthy balanced diet - low in saturated fat, plenty of wholemeal grains (cereal or bread). fruit and vegetables etc.

Saturated fat can increase blood cholesterol levels,

Exercising regularly - doesn't have to be excessive - at 74 in 2020, I do, weather permitting), a brisk walk every day for a minimum of an hour! (now the regular Covid-19 pandemic routine!)

Maintaining a healthy weight - lose excess weight with diet and exercise.

Limiting the amount of alcohol you drink, stop smoking - not good for lungs, therefore not good for your vital oxygen circulation!

Just like type 2 diabetes, you can do a lot for yourself!

AND there are NO NEGATIVE SIDE-EFFECTS !!!!!

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Summary of learning objectives and key words or phrases

Be able to describe the treatment of cardiovascular coronary heart disease using drugs.

Be able to discuss the advantages and disadvantages of using treatments such as statins, aspirin, anticoagulants like Warfarin, antihypertensives (ACE inhibitors), beta blockers, diuretics and importantly, the great value of alternative lifestyle changes.

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