Some Side Effects
Angiotensin-converting enzyme (ACE) inhibitors
Cough, usually dry and metallic
Rarely, a severe allergic reaction (angioedema)
Possibly worsening of kidney function when people already have kidney disease or when the artery to one of the kidneys is greatly narrowed
These drugs lower blood pressure and treat heart failure Heart Failure (HF) and prevent kidney damage in people with high blood pressure High Blood Pressure or diabetes Diabetes Mellitus (DM) . They also benefit people who have had heart attacks Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) .
People who have high blood pressure, heart failure, or prior heart attacks and who are treated with an ACE inhibitor live longer than people who do not take an ACE inhibitor.
Angiotensin II receptor blockers (ARBs)
Similar to ACE inhibitors, but cough is much less common
These drugs have equivalent effects and benefits to those of ACE inhibitors. In people with severe high blood pressure or heart failure, these drugs may be used in combination with an ACE inhibitor.
Dizziness, headache, constipation, and nausea
This drug may be more effective in women than in men.
Bleeding, especially when used with other drugs that have a similar effect (such as aspirin and other nonsteroidal anti-inflammatory drugs)
These drugs prevent blood from clotting. They are used to treat people who have unstable angina Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) or who have had a heart attack.
Bleeding, especially when used with other drugs that have a similar effect (such as anticoagulants)
With aspirin, stomach irritation
With ticlopidine and less so with clopidogrel, a small risk of reducing the white blood cell count
These drugs prevent platelets from clumping and blood clots from forming. They also reduce the risk of a heart attack. They are used to treat people who have stable or unstable angina or who have had a heart attack.
Aspirin is taken as soon as a heart attack is suspected. People with an allergy to aspirin may take clopidogrel or ticlopidine as an alternative.
Spasm of airways (bronchospasm)
Abnormally slow heart rate (bradycardia)
Cold hands and feet
Shortness of breath
With many beta-blockers, an increase in the triglyceride level and a decrease in the HDL level
These drugs reduce the workload of the heart and the risk of a heart attack and sudden death. They are used to treat people who have stable or unstable angina or microvascular angina or who have had a heart attack.
Calcium channel blockers
Nifedipine (sustained-release only)
Fluid accumulation (edema) in the ankles
Abnormal heart rhythms (arrhythmias)
With verapamil, constipation
With short-acting, but not long-acting, calcium channel blockers, possible increased risk of death due to heart attack, especially in people who have unstable angina or who have had a heart attack recently
These drugs prevent blood vessels from narrowing and can reverse artery spasm. Diltiazem and verapamil reduce the heart rate. Calcium channel blockers are used to treat people who have stable angina.
Glycoprotein IIb/IIIa inhibitors (a type of antiplatelet drug)
Bleeding, especially when used with other drugs that have a similar effect (such as anticoagulants or thrombolytic drugs)
Reduction of the platelet count
These drugs prevent platelets from clumping and blood clots from forming. They may be used to treat people who have unstable angina, particularly those who are undergoing percutaneous coronary intervention after a heart attack.
Temporarily fast heart rate (tachycardia)
These drugs relieve angina, prevent episodes of angina, and reduce the risk of a heart attack and sudden death. (However, risk reduction is much less than that with beta-blockers.) They are used to treat people who have stable or unstable angina or microvascular angina. For these drugs to remain effective over the long term, people need to go 8 to 12 hours without taking the drug each day.
Low blood pressure when a person stands
Confusion (especially in older people)
In some people who have had a heart attack, these drugs are used to relieve anxiety and pain if the pain persists despite use of other drugs.
Occasionally, muscle aches and pains, but rarely severe muscle pain (myositis)
Rarely, liver damage, but not more commonly than in people who are not taking the drug
These drugs lower cholesterol levels and help to heal damaged arteries, decreasing the chance of having a first or repeated heart attack or stroke.
Rarely, bleeding within the brain (intracerebral hemorrhage) or the digestive tract
These drugs dissolve blood clots. They are used to treat people who have had a heart attack.
* Doctors may use different combinations of drugs depending on the type of coronary artery disease the person has.
† Also known as hydroxymethylglutaryl-CoA (HMG-CoA) reductase inhibitors.