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Main medication groups in cardiology and vascular medicine

This page explains the main groups of medicines used in cardiology and vascular medicine. Examples are for information only: they are neither a prescription nor a complete list. Never start, replace or stop a medicine without medical advice.

Medicines for high blood pressure

  • ACE inhibitors: ramipril, perindopril, enalapril. They act on the renin–angiotensin system; kidney function and potassium monitoring may be needed.
  • Angiotensin II receptor blockers (ARBs): candesartan, valsartan, irbesartan, losartan. They are used when the indication fits the patient's clinical profile.
  • Calcium channel blockers: amlodipine, lercanidipine; in selected situations, verapamil or diltiazem. Choice depends particularly on heart rate and ventricular function.
  • Diuretics: indapamide or hydrochlorothiazide for certain cases of hypertension; furosemide or bumetanide mainly for congestion or oedema.
  • Beta blockers: bisoprolol, nebivolol, carvedilol, metoprolol. They may be prescribed for coronary disease, heart failure, rhythm disorders or selected cases of hypertension.

Heart failure

In heart failure with reduced ejection fraction, long-term treatment may combine complementary groups: an ACE inhibitor, ARB or sacubitril/valsartan; an evidence-based beta blocker; a mineralocorticoid receptor antagonist such as spironolactone or eplerenone; and an SGLT2 inhibitor such as dapagliflozin or empagliflozin. Loop diuretics, such as furosemide or bumetanide, mainly treat congestion. Starting and monitoring treatment depends on blood pressure, kidney function, potassium and clinical status.

Antiplatelets and anticoagulants

  • Antiplatelets: low-dose aspirin, clopidogrel, prasugrel or ticagrelor. They are used in certain coronary conditions, after angioplasty or in some arterial diseases.
  • Direct oral anticoagulants: apixaban, rivaroxaban, dabigatran, edoxaban. They are used for selected cases of atrial fibrillation or thromboembolic disease.
  • Vitamin K antagonists: warfarin or acenocoumarol, with INR monitoring. They remain essential in certain situations, including some mechanical heart valves.

Antiplatelets and anticoagulants are not interchangeable. Combining them increases bleeding risk and requires a precise medical indication.

Cholesterol-lowering medicines

  • Statins: atorvastatin, rosuvastatin, simvastatin. They lower LDL cholesterol and cardiovascular risk when indicated.
  • Cholesterol absorption inhibitor: ezetimibe, often added to a statin when the LDL target is not reached.
  • Injectable PCSK9-targeting treatments: evolocumab or alirocumab, reserved for selected situations, including some very-high-risk patients or familial hypercholesterolaemia.

Angina and coronary artery disease

Depending on symptoms, heart rate, blood pressure and heart function, treatment may include a beta blocker, calcium channel blocker, nitrate, ivabradine or ranolazine. Symptom treatment is combined with prevention of cardiovascular events.

Rhythm disorders

Rate control may use a beta blocker, diltiazem, verapamil or digoxin, according to the case. Rhythm control may use antiarrhythmics such as flecainide, amiodarone or sotalol. Their indications and contraindications differ greatly according to heart disease, kidney function, ECG and interactions. Medical assessment is required.

Vascular diseases

In leg arterial or carotid disease, medicines mainly address overall prevention: antithrombotic treatment when indicated, lowering LDL cholesterol, controlling blood pressure and diabetes, and stopping smoking. Venous thrombosis or pulmonary embolism may require anticoagulation for a duration suited to the cause and risk of recurrence.

Monitoring and safety

Kidney function, potassium, sodium, blood pressure, heart rate, ECG and bleeding risk may need monitoring, depending on treatment. Always report other medicines, supplements, possible pregnancy, allergies and any history of bleeding. If side effects occur, contact a healthcare professional; do not abruptly stop cardiovascular treatment without medical instructions.

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