Anti-Platelet and Anti-Clotting Medications
Anti-clotting drugs inhibit or dissolve blood clots that may cause heart attacks and strokes. Due to their anti-clotting effect however, their use also carries the risk of excessive bleeding (since the blood does not easily clot). Under certain conditions such bleedings can lead to complications, including hemorrhagic strokes.
As the name suggests, the antiplatelet drugs decrease the aggregation of blood platelets or thrombocytes and thrombus formation. More specifically, they inhibit the production of thromboxane, a chemical signal that makes the platelets aggregate. The best-known antiplatelet drug is Aspirin (originally developed as a pain reliever). Other classes of antiplatelets include adenosine diphosphate receptor inhibitors, glycoprotein IIB/IIIA inhibitors and adenosine reuptake inhibitors.
Anticoagulants are drugs that prevent coagulation and the formation of blood clots. They target blood clotting factors, a series of blood plasma proteins needed for the formation of blood clots. Anticoagulants are used to treat and prevent various afflictions such as deep vein thrombosis, embolisms, heart attacks and strokes. Heparin, a naturally-occurring anticoagulant, has been the standard anticoagulant for a long time, however it is increasingly replaced with newer and more effective drugs. Newer examples of anticoagulants are low-molecular weight heparin and direct thrombin inhibitors.
Nitroglycerin, has been used for over 100 years to treat episodes of acute angina attacks. Nitroglycerin, which is converted into nitric oxide in our bodies, relaxes the smooth muscle cells within the blood vessel walls, causing the vessels to widen and the blood pressure to drop. As veins dilate more than the arteries, the pressure on the ventricle of the heart decreases considerably, causing the chest pain to subside.
Beta-blockers are drugs that reduce the heart rate and lower the blood pressure. They are prescribed to patients at risk of heart and angina attacks (e.g. people with high blood pressure) or to patients with abnormal heart activity (cardiac arrhythmias). Beta-Blockers are also used for reducing the risk of death during the recovery after heart surgeries.
Calcium Channel Blockers (CCBs)
Like beta-blockers, calcium channel blockers reduce the heart rate and lower the blood pressure. However, there is currently no strong evidence that any calcium channel blocker improves survival rates. Moreover, overdosing causes dangerously low blood pressures and slow heart beats.
Angiotensin converting enzyme (ACE) inhibitors are to a large extent prescribed to people with diabetes and high blood pressure. They reduce the production of a protein called angiotensin that causes arteries to narrow. As a result, ACE Inhibitors cause a systematic dilation of the blood vessels and a decrease in arterial blood pressure. Some clinical studies suggest that (ACE) inhibitors also reduce risk of heart attack and stroke.
This is the newest class of blood pressure lowering agents. Similar to the ACE-inhibitors they block the action of the protein angiotensin on its target receptor. They effectively lower blood pressure, are well tolerated and are also effective in patients with heart failure.
Statins are newly developed drugs that lower the low-density lipoproteins (LDL), the so-called “bad cholesterol” in the blood. Clinical studies have shown that lowering the “bad cholesterol” reduces the risks of heart disease significantly. A recent study even suggests that aggressive treatment may reverse some of the symptoms caused by coronary artery disease.