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Question:
Why is my husband on multiple medications after his heart attack?
My husband had a heart attack. He never had HBP or cholesterol problems. It was called calcification and had a stent put in. He is now on 2 BP meds and a blood thinner and baby aspirin and cholesterol med. He never had HBP but now he does, in the 140's. Why? Please help. We can't seem to get answers. I think something is wrong. Thank you.
submitted by Judy from Florida on 8/30/2015
Answer:
by Texas Heart Institute cardiologist, Michael J. Mihalick, MD
Dear Judy,
Hypertension and elevated cholesterol are not the only risk factors for heart disease. Some of the others are smoking, family history, diabetes, male sex, and age. It is routine for patients with stents to be placed on 'dual antiplatelet therapy', usually clopidogrel and aspirin. Other drugs such as Effient and Berlinta may be substituted for the clopidogrel. As far as the stent is concerned, 2 drug therapy should be continued for 6-12 months. However, recent studies and my own experience indicate that there is ongoing benefit to continue the antiplatelet drugs indefinitely often dropping aspirin to reduce bleeding risk. Taking the more powerful antiplatelet drugs do increase bleeding risk and need to be stopped 5 days prior to elective surgery (this may be shortened to 2-3 days if platelet function tests are followed). The bleeding is rarely fatal and can be effectively reversed, unlike a heart attack or stroke. The decision to continue these drugs is based in the individual situation (risk vs. benefit).Blood pressure medications such as beta blockers, ACE inhibitors, angiotensin receptor blockers, and aldosterone antagonists have been found to be quite effective in relieving stress on the injured heart and prolong survival.Statin drugs lower bad cholesterol and have an anti-inflammatory effect on the blood vessels. They have been shown to be beneficial in patients who have had heart attacks and strokes even when the baseline cholesterol is normal.
I assume that the doctors have decided that your husband will benefit from this treatment. I have been in practice long enough to see patients like your husband go into remission with this treatment. Stopping smoking, getting regular exercise, and following a prudent diet like the Mediterranean (Omega) diet are just as important as the drugs discussed above.
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Updated September 2015
