Drugs for Coronary Artery Disease: ACE Inhibitors and ARBs
ACE inhibitors and ARBs may be part of your treatment for coronary artery disease.

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Drugs for Coronary Artery Disease: ACE Inhibitors and ARBs

Your heart is a hard-working muscle that pumps more than a thousand gallons of blood each day throughout your body. While the heart sends oxygen-rich blood to fuel all your organs and tissues, your heart itself needs oxygen-rich blood to do its job. The heart's own vital blood supply is delivered by coronary arteries.

Over time, the body's arteries, including the coronary arteries, can develop a buildup of a waxy substance called plaque. Plaque narrows the coronary arteries and reduces blood flow to your heart muscle. A common symptom of reduced blood flow to the heart is chest pain. This chest pain is also called angina. It can feel like squeezing and pressure in the chest. Pain may also occur in the shoulders, back, neck, arms or jaw. In some cases, angina feels like indigestion.

As the arteries build up with plaque, the surface of the plaque can break open. This causes a blood clot to form on the surface of the plaque and the inner lining of the coronary artery. If the clot becomes large enough in the artery, it can block the flow of oxygen-rich blood to the portion of heart muscle fed by the affected artery. Blocked blood flow to the heart muscle can cause a heart attack.

When the coronary arteries are narrowed or blocked by plaque, this is called coronary artery disease (CAD). There are medications that doctors may prescribe to help the blood flow easier through arteries. Two of these - ACE inhibitors and ARBs - are designed to block the effects of angiotensin, a hormone that causes blood vessels to narrow or constrict. These medicines let the heart work more efficiently and with less strain.

ACE inhibitors
Angiotensin-converting enzyme (ACE) inhibitors help relax and widen the blood vessels. They work by decreasing the amount of angiotensin II that is made by the body. This lowers blood pressure and eases the work of the heart, allowing it to pump more efficiently. Possible side effects of ACE inhibitors include skin rash, loss of taste, chronic dry, hacking cough, and in rare instances, kidney damage.

Angiotensin is a natural chemical in our bodies. It narrows your blood vessels and thickens the walls of blood vessels. Angiotensin II-receptor blockers (ARBs) block the effects of angiotensin on arteries. ARBs lower blood pressure and allow the heart to work more efficiently. They improve the flow of oxygen-rich blood to the heart.

ARBs are sometimes better tolerated by people with CAD than are ACE inhibitors. ARBs are less likely to cause a dry cough. Side effects can include dizziness or lightheadedness when standing or getting out of bed.

If you have been prescribed either of these, talk to your doctor about any questions or concerns you may have.

What you can do
While conditions of the heart like CAD can be seen as common, they should be taken seriously so you can have the greatest success in managing them. Here are some ideas for maximizing your health.

To help decrease the effects of CAD, you will want to live a healthier lifestyle. Small changes can make a big difference. Make healthy food choices. Be active. Maintain a healthy weight. Don't smoke. If you choose to drink alcohol, limit intake to one drink a day for women, two for men. Take time to talk with your doctor about what healthy lifestyle goals are right for you. Other things you can do include:

  • Learn as much as possible about your condition
  • Follow your treatment plan
  • Make your health care team, including your doctor, your partners
  • Take all your medications as prescribed
  • Know what side effects to watch for
  • Keep all your medical appointments

If you are physically inactive or you have a health condition such as arthritis, diabetes, heart disease, pregnancy or other symptoms, check with your doctor before starting an exercise program or increasing your activity level. He or she can tell you what types and amounts of activities are safe and suitable for you.

By Mary Small, Contributing Writer
Created on 11/03/2009
Updated on 08/23/2013
  • American College of Cardiology. CardioSmart. Coronary artery disease.
  • American Heart Association. Cardiac medications.
  • National Heart, Lung, and Blood Institute. What is coronary heart disease?
  • National Institute on Aging. Aging hearts and arteries.
Copyright © OptumHealth.
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