By Erin Golden
Getting a stent put in to help keep your arteries from narrowing is only the first step in your fight against atherosclerosis, a condition in which plaque builds up in the vessels supplying blood to your heart, causing reduced blood flow. To keep your heart healthy, you’ll need to carefully follow your cardiologist’s instructions about medications — each of which will play different and important roles in helping you heal and preventing future blockages.
It’s also crucial to make sure your doctor knows about any other types of medications you are currently taking because they could interfere with your new regimen.
Medications prescribed for patients with stents typically fall into three categories.
Clots that disrupt the flow of blood to and from your heart can lead to a heart attack. Blood-thinning medications aim to prevent a heart attack from happening initially or from recurring, if you’ve already had one. They work by making sure the elements that can form a clot, such as platelets, don’t stick together well. (Platelets are a type of blood cell.)
Aspirin is probably the simplest and best-known medication in this category — and one you’ll have to take regularly after your surgery indefinitely. Depending on the type of stent you have put in, your doctor might prescribe an additional antiplatlet medication that you’ll take for a month or six weeks or even up to a year.
It’s crucial that you take these medications exactly as directed by your doctor and that you get regular blood tests so your doctor can tell how well the treatment is working. The American Heart Association also recommends talking to your doctor before you start taking any other prescription or over-the-counter drugs, including vitamins, cold medicine, sleeping pills and antibiotics. Adding another pill to your daily regimen could give your medication a stronger or weaker effect — both of which could be harmful.
Lowering your cholesterol levels — and keeping them that way — is another crucial element in keeping your heart healthy. Too much cholesterol circulating in your bloodstream means a greater risk that it will stick to your arteries, making them narrow or creating blockages.
Statins are drugs that reduce cholesterol by fighting off the substances that form it. Statin medications might also help your body get rid of cholesterol it has already produced.
Typically, “high” cholesterol is considered an LDL (“bad” cholesterol) level of 130 mg/dL or higher. But the fact that you’ve had stent surgery provides your doctor with an additional consideration — which may mean that you get a statin prescription even if you didn’t think you needed one before.
Doses and the specific type of this medication can vary considerably, depending on your cholesterol levels and other risk factors.
The good news: Statins can have a major effect on cholesterol levels. The bad news: It’s not the sort of drug you can take for a while and then stop. For many people, a statin prescription is something to keep for life.
“It’s important for patients to understand that even though the stent procedure may be an hour, they need to be sure they’re actively involved in the secondary prevention of atherosclerosis,” said Amar Krishnaswamy, MD, an interventional cardiologist in the Cleveland Clinic’s Department of Cardiovascular Medicine. “Atherosclerosis is a lifelong process and protecting themselves from it is also.”
Even if you’ve never thought of yourself as someone with particularly high blood pressure, keeping those levels low will likely be one of your doctor’s goals after your procedure.
There are several different types of anti-hypertensive medications and each works in a slightly different way. Beta blockers, for example, block some signals from nerves and hormones to the heart and blood vessels to lower blood pressure. Angiotensin-converting enzyme (ACE) inhibitors keep your body from producing a hormone called angiotensin — which then allows your vessels to stay open wide enough for good blood flow. Calcium channel blockers keep calcium out of heart and blood vessel cells, which relaxes them and lowers blood pressure.
You doctor will recommend a type of blood pressure medication based on your needs. In some cases, the best course of action might include a combination of medicines. But no matter what option fits you, blood pressure drugs can have far-reaching effects on your health.
“These medications are beneficial not only for controlling blood pressure, but reducing strain and stress on the heart,” Dr. Krishnaswamy said.
Published August 6, 2014
Erin Golden is a journalist based in Nebraska.