Your heart is the center of your cardiovascular system. It is involved in many of the daily functions that bring your body to life. Having a healthy heart is vital to your overall health. Two of the simplest yet most important ways to help your heart health are through diet and exercise.

Path to improved health

Improving your heart health is easier when you know how to eat and how to exercise. Follow these tips to get the most out of your diet and exercise plan.

Diet

The foods you eat can affect your weight, your hormones, and the health of your organs, including your heart. Eating a healthy diet can help reduce the risk of heart disease and stroke.

• Choose healthy fats. Despite what you may have heard, some fats are good for you. When you use fats for cooking, choose monounsaturated fats, such as olive oil or canola oil. Avocados are also a good source of monounsaturated fat. Polyunsaturated fats and omega-3 fatty acids are also healthy choices. Polyunsaturated fats are found in nuts and seeds. Omega-3 fats are found in fish, such as tuna and salmon. In general, you should try to avoid trans fats. Trans fats are usually found in processed foods and snacks such as crackers or snack cakes. To see whether a food contains trans fats, look for the words “partially hydrogenated” on the ingredient label.
• Go whole-grain. Whole-grain breads or pastas are higher in fiber and complex carbohydrates. Choose them instead of white breads or regular pastas for sandwiches and meals.
• Eat plenty of fruits and vegetables. They contain fiber, vitamins, and minerals that are good for your body. They also add flavor and variety to your diet.
• Prepare meat healthfully. Baking, broiling, and roasting are the healthiest ways to prepare meat and poultry. Trim any outside fat or skin before cooking. Lean cuts can be pan-broiled or stir-fried.
• Don’t forget beans. Dry beans, peas, and lentils offer protein and fiber. Try substituting beans for meat in a favorite recipe, such as lasagna or chili.
• Choose low-fat dairy. Go for fat-free or low-fat versions of milk, yogurt, and cheese products.
• Pack in protein. Eat protein–rich foods, including fish, lean meats, skinless poultry, eggs, nuts and seeds, and beans.
• Try a diet. The DASH (Dietary Approaches to Stop Hypertension) eating plan is a heart-healthy approach that lowers blood pressure and bad cholesterol in your blood. Or try the Mediterranean Diet for another healthy approach to eating.

What should I NOT eat?

A heart-healthy diet limits some nutrients. These include:

Sodium. Flavor foods with spices or no-salt seasonings instead of salt. Watch out for prepackaged foods, sauces, canned foods, and processed foods. They can all contain a high amount of sodium.

Saturated and trans fats. Saturated fats are found in fatty meats, poultry skin, whole-milk dairy, butter, lard, and coconut and palm oils. Trans fats are found in some desserts, microwave popcorn, frozen pizza, stick margarines, and coffee creamers. Look for the words “partially hydrogenated oil” on the food label.

Added sugar. Sweetened drinks, snacks, and sweet treats are the main source of added sugars in the United States. These include sodas, sweetened coffee and tea, energy drinks, cakes, pies, ice cream, candy, syrups, and jellies. Limit these types of foods and drinks.

Alcohol. Limit your intake of alcohol. Men should have no more than 2 drinks a day. Women should have no more than 1 drink per day. Too much alcohol can raise your blood pressure and cause you to gain weight. It can also contribute to or worsen heart failure in some people.

How much should I weigh?

Talk to your family doctor about your ideal weight because every person is different. If you’re overweight, the extra pounds put extra stress on your heart. Losing weight can help your heart stay healthy. Remember that losing just 10% of your body weight will reduce your risks for diabetes and heart disease.

Exercise

Exercise makes your heart stronger. This helps it pump more blood with each heartbeat. This delivers more oxygen to your body. With more oxygen, your body functions more efficiently.

Exercise can also lower blood pressure. It reduces your risk of heart disease and reduces levels of LDL (bad cholesterol). Bad cholesterol can clog the arteries and can cause a heart attack. At the same time, exercise can raise levels of HDL (good cholesterol). HDL helps protect against a heart attack by carrying fatty deposits out of the arteries.

When combined with a healthy diet, exercise can speed up weight loss. Regular exercise builds lean muscle, which burns more calories than fat. This helps you burn calories faster, even when you’re sitting still.

What’s the best type of exercise for my heart?

Aerobic exercise causes you to breathe more deeply. It makes your heart work harder to pump blood. Aerobic exercise also raises your heart rate (which burns calories). Examples of aerobic exercise include walking, jogging, running, dancing, swimming, and bicycling.

How much exercise do I need?

If you haven’t been exercising, try to work up to 30 minutes 4 to 6 times a week. Your doctor may recommend a different exercise regimen based on your health. Alternate exercise days with rest days or days you do a very different type of exercise. This will help prevent injuries.

How will I fit exercise into my busy schedule?

There are lots of ways to raise your heart rate during your regular day. Some examples include:

• Take the stairs instead of the elevator.
• Walk during a coffee break or lunch.
• Walk to work, or park at the end of the parking lot so you have to walk farther.
• Walk more briskly.
• Do housework at a quicker pace and more often (for example, vacuuming every day).
• Rake leaves, mow your lawn, or do other yard work.

Things to consider

Diet and exercise are an important part of your heart health. If you don’t eat a good diet and you don’t exercise, you are at increased risk of developing health problems. These include high blood pressure, high cholesterol, obesity, type 2 diabetes, and heart disease. These increase your risk of heart attack and stroke.

Questions to ask your doctor

• Should I eat a special diet to keep my heart healthy?
• I am overweight. How can I lose weight to make my heart healthier?
• Am I healthy enough to begin exercising?
• How much should I exercise?
• I already heave heart disease. Can diet and exercise make me better?

Resources

National Heart, Lung, and Blood Institute: Heart-Healthy Lifestyle Changes

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What is homocysteine?

Homocysteine is an amino acid (a building block of protein) that is produced in the body.

How is a high homocysteine level harmful?

High homocysteine levels in the blood can damage the lining of the arteries. High levels may also make the blood clot more easily than it should. This can increase the risk of blood vessel blockages. A clot inside your blood vessel is called a thrombus. A thrombus can travel in the bloodstream. From there, it can get stuck in your:

• Lungs (called a pulmonary embolism)
• Brain (which can cause a stroke)
• Heart (which can cause a heart attack)

Some people have very high levels of homocysteine. They are at an increased risk for heart disease.

What causes a high homocysteine level?

Homocysteine is normally changed into other amino acids for use by the body. Vitamin B helps your body use the homocysteine. If your homocysteine level is too high, you may not be getting enough B vitamins.

Most people who have a high homocysteine level don’t get enough folate (also called folic acid), vitamin B6, or vitamin B12 in their diet. Replacing these vitamins often helps return the homocysteine level to normal. Other possible causes of a high homocysteine level include:

• Low levels of thyroid hormone
• Kidney disease
• Psoriasis
• Some medicines
• When the condition is common in your family

How is the homocysteine level measured?

Homocysteine is measured using a simple blood test. Your doctor will order the test only if they suspect you have high levels. If your homocysteine level is too high, you need to lower it. This is especially important if you have blockages in your blood vessels. Sometimes your doctor may take a watchful waiting approach. This means they will monitor your level closely but not take steps to lower it. Your doctor may do this if you have no other major risk factors for cardiovascular disease and you don’t have atherosclerosis (a buildup of plaque in your arteries). If your homocysteine level increases further, you may need to lower it.

No studies have shown that lowering homocysteine levels helps reduce strokes, heart attacks, or other cardiovascular conditions. But a high homocysteine level is a risk for heart disease. So, it’s a good idea to lower it if you can.

Path to improved health

How can I lower a high homocysteine level?

Eating more fruits and vegetables can help lower your homocysteine level. Leafy green vegetables such as spinach are good sources of folate. Other good sources of folate include:

• Many breakfast cereals
• Fortified grain products
• Lentils
• Asparagus
• Most beans

You may need to increase the amount of vitamin B-6 in your diet. Foods that are rich in vitamin B-6 include:

• Fortified breakfast cereals
• Potatoes
• Bananas
• Garbanzo beans (chickpeas)
• Chicken

You also may need to increase the amount of vitamin B-12 you eat. Good sources of vitamin B-12 include:

• Dairy products
• Organ meats (such as liver)
• Beef
• Some types of fish

Adjusting your diet may not be enough to lower your homocysteine level. If it’s not, your doctor may suggest that you take a folate supplement. You may also need to take a vitamin B-6 and vitamin B-12 supplement.

Things to consider

If you start taking folate or vitamin B supplements, you should have your homocysteine level rechecked after 8 weeks. If your homocysteine level remains high, your doctor may have you try a higher dose. You may need to have some tests to see if you have another health condition that causes high homocysteine levels. If you have had a high homocysteine level, you may need to have your level checked more regularly (2 or 3 times a year).

Questions to ask your doctor

• What is causing my homocysteine level to be high?
• Could a high level be the sign of another condition?
• Can I lower my homocysteine level through diet alone?
• Should I take a supplement?
• Can I ask my doctor to check my homocysteine level even if I have no symptoms?

Resources

National Institutes of Health, MedlinePlus: Homocysteine Test

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Are you at high risk for heart disease? Take a moment to consider your lifestyle, family history, and general health. You and your doctor can use this information to tackle potential problems and maybe even lower your risk.

Path to Improved Health

The following factors may impact your risk of heart disease.

Age

Men older than 45 years of age and women older than 55 years of age (or who have gone through menopause) are at greater risk for heart disease. Also, the rates of heart attack over the last 20 years have been increasing for women 35 to 54 years of age.

Family history

It is important for you to know what diseases and conditions run in your family and to tell your doctor. Talk to your parents, grandparents, siblings, aunts, and uncles. Ask them who in your family has had a heart attack, stroke, or other serious health problem. With this information, your doctor can recommend the best kinds of screening tests and preventive treatments.

Cholesterol

If you don’t know your cholesterol level, ask your doctor if you should have it checked. There are good (HDL cholesterol) and bad (LDL cholesterol) types. To reduce and prevent high levels of bad cholesterol, eat a healthy diet and exercise regularly. Some people who have high cholesterol levels may also need to take medicine to keep their levels under control.

Blood pressure

If your blood pressure is high, there are things you can do to lower it. Try:

• Losing weight
• Exercising
• Not smoking
• Cutting down on sodium (salt)
• Cutting down on alcohol

Many people may also need to take medicine to control their blood pressure.

Smoking

Quitting smoking is the single best change you can make for your health. Talk to your family doctor about how to quit and stay tobacco-free. If you live with a smoker, breathing their smoke can also affect your health. Encourage the smoker to quit.

Diet

A healthy diet includes vegetables, fruits, lean meats, fish, beans, whole grains, and healthy fats. Limit the amount of processed foods (such as hot dogs), white flour (such as crackers and white bread), and sweet or sugary foods (such as soda and dessert foods) you eat. You may also need to avoid foods that are high in sodium, which can increase blood pressure. Sodium is found in table salt and many prepared foods, especially canned foods.

Although some research suggests alcohol can help protect against heart disease, moderation is the key. Limit how much alcohol you drink. This means no more than one alcoholic drink per day for women, and two alcoholic drinks a day for men.

The Mediterranean Diet is one good example of a heart-healthy diet that follows these guidelines. If you have questions about making changes to your diet, talk to your doctor. They can help you make better choices or refer you to a dietician.

Weight

Being overweight puts extra strain on your heart and blood vessels. A healthy diet with portion control, wise food choices, and regular exercise can help you lose weight gradually and safely. It can also help you keep it off. Talk to your doctor about the best ways for you to lose weight.

Exercise

Exercise can help prevent heart disease and many other health problems. You’ll also feel better and help keep your weight under control if you exercise regularly. If you haven’t exercised for a while or have health problems, talk to your doctor before you start an exercise program. Exercising 30 to 60 minutes, 4 to 6 times a week is a good goal, but any amount is better than none.

Things to Consider

Heart disease can lead to heart attack or stroke. Often there are warning signs of heart disease. These can include elevated “bad” cholesterol levels and high blood pressure. But these warning signs don’t always have symptoms. That is why it is important to work with your doctor to assess your risk.

Questions to Ask Your Doctor

• What are the warning signs for heart disease?
• Is my blood pressure in the normal range?
• Do I have high cholesterol levels?
• Can I be at risk for heart disease even if I have no family history of heart disease?
• How often should I be monitored for heart disease?

Resources

American Heart Association: What is Cardiovascular Disease?

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High cholesterol can begin in childhood. High cholesterol levels are likely to continue to rise as a child grows into a teen and adult. This increases your child’s risk for cholesterol-related health problems.

What are the risks of high cholesterol levels?

Your child’s body needs some cholesterol to protect nerves, make cell tissues, and produce certain hormones. But too much cholesterol damages blood vessels. It builds up along blood vessel walls. This forms sticky, fatty deposits called plaque. Studies show that plaque can begin to form in childhood. It is more likely to form when a child’s cholesterol levels are high.

High cholesterol levels increase your child’s risk of heart disease and stroke when he or she gets older. Heart disease is the leading cause of death in the United States. The risk is higher in people who:

• Have a family history of heart disease or strokes
• Have diabetes
• Are overweight or have obesity
• Have unhealthy eating habits
• Are not physically active
• Smoke or are exposed to second-hand smoke

Where does cholesterol come from?

The liver makes all the cholesterol your child’s body needs. He or she also gets cholesterol from food, including animal products such as eggs, meats, and dairy products.

What is the difference between “good” cholesterol and “bad” cholesterol?

Low-density lipoproteins (LDL) are often called “bad” cholesterol. They deliver cholesterol to the body. Some people’s bodies make too much LDL cholesterol. LDL levels also are increased by eating foods high in saturated fat, trans fats, and dietary cholesterol.

High-density lipoproteins (HDL) are often called “good” cholesterol. They remove cholesterol from the blood. A healthy level of HDL may help protect against heart disease. Exercise can increase the amount of HDL cholesterol the body produces. Avoiding trans fats and following a healthy diet also can increase HDL levels.

Sometimes cholesterol levels are high because of a high LDL level. This increases the risk for heart disease or stroke. Other times, cholesterol levels are high because of a high HDL  level. This does not increase the risk for heart disease or stroke.

Should my child be tested for high cholesterol levels?

The American Academy of Pediatrics recommends all children be tested for hyperlipidemia (fat levels in the blood) between the ages of 9 and 11. Your child should have a cholesterol test if there is a family history of high cholesterol. Your doctor will also recommend testing if your child or teen has diabetes.

What causes high cholesterol levels in children?

The following are factors that can cause high cholesterol levels in children:

• Family history of high cholesterol levels (for example, a parent who has high cholesterol levels)
• Lack of physical activity
• Obesity

Path to improved well being

You can help your child maintain a healthy weight by making healthy choices. Teach him or her to make healthy food choices and be physically active. Here are a few tips:

• Offer your child at least 5 servings of fruits and vegetables each day. For example, have healthy snacks such as apples, bananas, carrots, and celery readily available.
• Include plenty of low-fat proteins, vegetables, and whole grains in the meals you make.
• Avoid saturated fat and trans fats. Saturated fats are usually found in animal products (for example, fried or fatty meats). You can also find them in dairy products (for example, cheese and butter). Many snack foods (for example, cookies and chips) are high in saturated fat. Trans fats are usually found in processed foods (for example, doughnuts and crackers). They are also in fried foods (for example, French fries and onion rings).
• Avoid fast-food dining. If you do eat at a fast-food or sit-down restaurant, choose the healthiest options available. Try a salad with a grilled or broiled piece of meat and a fruit cup.
• Limit your child’s screen time (TV, computer, cell phone, or game station) to no more than 1 to 2 hours a day. Set a good example by limiting your own screen time, too.
• Encourage your child to find physical activities he or she enjoys and get active. Aim for at least 1 hour of active play every day.
• Make physical activity part of your whole family’s lifestyle. Take a walk, go for a bike ride, or do chores together. Plan active family outings.

Things to consider

Healthy eating and physical activity are the first choice to lower a child or teen’s high cholesterol levels. If these don’t help, your family doctor may consider prescribing a cholesterol-lowering medicine. This type of medicine may be needed if your child has diabetes or is overweight or obese.

Not all medicines are safe for use in children. Do not give your child a cholesterol-lowering medicine that isn’t specifically prescribed to him or her.

Questions to ask your doctor

• Should I have my child’s cholesterol level tested?
• If my child’s cholesterol level is high now, will it always be high?
• How often should my child’s cholesterol level be tested?
• Does my child need to see a specialist?
• Do you recommend any other diagnostic tests?
• What are our options for cholesterol treatment?
• What are the benefits, risks, or side effects of these treatments?

Resources

Centers for Disease Control and Prevention: Abnormal Cholesterol Among Children and Adolescents

National Institutes of Health, MedlinePlus: Cholesterol

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An electrocardiogram (also known as an EKG or ECG) is a painless test that measures the electrical activity of your heart. It records this activity as short, wavy lines that dip up and down on graph paper. The size and shape of these dips can reveal many things about the health of your heart.

Your doctor may order an EKG for several reasons. They may order the test to see if you have heart disease or heart damage. An EKG can be used to see if medications are affecting your heart. Your doctor also may use an EKG to check on any implanted heart equipment (a pacemaker, for example) you have.

An EKG is used to diagnose:

• Arrhythmia – A heartbeat that’s too fast, too slow, or irregular.
• Cardiomyopathy – A heart muscle that is too thick or parts of the heart that are too large.
• Congenital heart defects – Birth defects of the heart.
• Coronary heart disease – Lack of blood flow to the heart muscle.
• Heart attack – Damage to the heart caused from a blocked artery.
• Heart failure – A heart that is not pumping with enough force.
• Heart valve disease – Problems with the heart valves.
• Pericarditis – Inflammation of the sac surrounding the heart.

An EKG will determine if your heart beats normally by measuring any abnormality in heart rate or rhythm. If you’re healthy, your heartbeat should be consistent and even.

Path to improved health

If your doctor determines that you should have an EKG, the test will take place either in the doctor’s office or at a hospital. A technician typically performs the test.

The technician may ask you to change into a hospital gown. After changing, you’ll be asked to lie on an exam table or on a bed. The technician will attach 12 to 15 electrodes (stickers) to your chest, arms, and legs using stickers. The stickers may be cold but will not hurt when they are attached to your skin. Sometimes, the technician may have to shave or clip your body hair to make the electrodes stick to your body the way they should.

Once the electrodes are attached, the test will begin. These electrodes can detect the electrical currents of your heart, using your body’s natural electrical system. The EKG machine will record the impulses that make your heartbeat. These impulses will create the wavy lines on the graph paper.

EKGs are painless. The only challenge, especially for children, will be lying completely still for the test. A standard test will usually last only a few minutes. During the test, you can breathe normally. Depending on what the doctor is looking for, the technician may ask you to hold your breath for a short time during the test.

The results of the EKG will be available immediately. If you had your EKG in the doctor’s office, your doctor may go over your results with you right then. Typically, though, your doctor will also have cardiologist (a doctor who specializes in heart health) review your results, too.

Things to consider

An abnormal result on your EKG does not always mean that your health is in danger. It could mean that your heart has a normal variation to its rhythm. This does not affect your health.

Other times, an abnormal EKG can be a sign of a true medical emergency. For example, EKGs can reveal if you’ve had or are having a heart attack.

A heart problem may not always show up on an EKG. If you believe that there is something wrong with your heart even after a normal result on your EKG, discuss your concerns with your doctor. You may also want to get a second opinion.

Questions to ask your doctor

• Why are you ordering an EKG?
• How long will my EKG take?
• Can I take my regular medication before my EKG appointment?
• Can I have an EKG if I am pregnant?
• When will you have my results?
• Will you notify me of my test results even if they are normal?
• Will you have to put my small child to sleep for the EKG?

Resources

American Heart Association: Electrocardiogram (ECG or EKG)

National Heart, Lung, and Blood Institute: Electrocardiogram

National Institutes of Health, MedlinePlus: Electrocardiogram

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People who have diabetes are more likely to get heart disease. When you have diabetes, your blood sugar level is often much higher than it should be. Too much sugar in the blood can cause damage to many parts of the body, including blood vessels. Some lifestyle habits may also raise the risk of heart disease.

Diabetes, being overweight, high blood pressure, and heart disease are related. But there are things you can do to reduce the risks of all four conditions. Diet and exercise are good ways to control your blood sugar level, lower your blood pressure, and cut your risk of getting heart disease. When diet and exercise don’t help enough, medicines can help control blood sugar levels, lower cholesterol levels, and control blood pressure.

Controlling diabetes – Path to improved health

There are many things you can do to be proactive about your health. Taking care of yourself is especially important when you have diabetes. Some of the things you would do to control diabetes will also lower your risk for heart disease.

Keep your blood sugar level under control.

Controlling your blood sugar level will lower your risk of heart disease. Many people who have diabetes check their blood sugar level every day. This confirms their medicines and/or insulin, diet, and exercise are working to keep their blood sugar in a normal range.

Lose weight—and keep it off.

Losing weight helps a lot of health problems. For example, if you’ve been told your blood pressure is too high, losing weight can bring it down. If your blood sugar level has been hard to control, losing weight can help.

Weight loss is important if you have a lot of extra weight around your waist and abdominal area. People who tend to carry extra weight around their waist are more at risk for heart disease than people who have extra weight in the hips or thighs. Even losing just 10 pounds can help your blood pressure, sugars, and the risk for heart problems. If you need help losing weight, ask your family doctor for advice. He or she can help figure out a safe and healthy plan for you.

Lower your cholesterol level.

Cholesterol is a waxy substance your body uses to protect nerves, make cell tissues, and produce certain hormones. All the cholesterol your body needs is made by your liver. Cholesterol in the food you eat (such as eggs, meats, and dairy products) is extra. Too much cholesterol in your blood can clog your arteries.

There are two types of cholesterol. LDL (which stands for low-density lipoprotein) is the so-called “bad” cholesterol that can clog your arteries and lead to heart disease. HDL (which stands for high density lipoprotein), is the “good” cholesterol that carries unneeded cholesterol away from body tissues. This lowers your risk of heart disease.

If your doctor says your cholesterol level is too high, what can you do about it? It helps to lose weight and eat a healthy diet.

You should limit the amount of fatty and cholesterol-rich foods you eat. There are many cookbooks available that contain low-fat, low-cholesterol recipes and meal suggestions. If you need help figuring out how to change your diet, your doctor might refer you to a dietitian. A dietitian has special training in planning healthy diets.

If diet alone doesn’t lower your cholesterol, certain medicines can help do that. You and your doctor can talk about these medicines. The medicine that’s best for you depends on your special needs and medical condition.

Increase your physical activity.

Along with diet, exercise is very important for people who have diabetes. Diet and exercise work together to help your body work properly. If you’ve changed your diet to lose weight, exercising can help you lose weight faster. Even if you are not losing weight, do not get discouraged. Adding exercise to your routine will still make a positive impact on your health.

You and your doctor can plan exercises that will work best for you and are safe for you. You don’t need a gym or expensive equipment to get good exercise. Brisk walking is great exercise. Climbing stairs instead of taking an elevator is another good thing to do.

Like eating a healthy diet, exercise will help keep your blood sugar level normal and can lower your risk of heart disease.

Control your blood pressure.

People who have diabetes often also have high blood pressure. High blood pressure is a big risk factor for stroke. It also increases your risk for heart disease and kidney disease.

The same lifestyle changes that control blood sugar levels and lower your risk of heart disease may also keep your blood pressure at safe levels. Weight loss and exercise are important. The more weight you lose, the more you lower your blood pressure. It’s also important not to drink very much alcohol.

If your blood pressure doesn’t come down enough with diet and exercise, your doctor might have you take medicines to help.

If you smoke, stop smoking.

Smoking is bad for everyone, but it’s even worse for people who have diabetes. That’s because it damages the blood vessels. If you have diabetes and smoke, you double your risk of getting heart disease. If you keep smoking while you try to reduce other risks (such as losing weight), you won’t be able to exercise as much. This means you probably won’t lose the weight you need to.

Things to consider

The higher your blood sugar, the higher your risk for developing heart disease. This means if your blood sugar is left uncontrolled, it can really damage your heart. Other factors can increase your risk even more, including smoking or being overweight. Having these risk factors likely means you’ll develop heart problems sooner. And your heart problems will be more severe.

If you have diabetes, talk to your doctor about the best way to manage your blood sugar. Ask the doctor to recommend an exercise program for you. Ask your doctor to refer you to a dietician.

Questions for your doctor

• Do I have risk factors that increase my likelihood for developing heart disease?
• If I have type 2 diabetes, can I manage it with diet and exercise alone?
• If I take medicine to control my blood sugar, do I really need to diet and exercise?
• Should I also see a cardiologist if I have diabetes?

Resources

American Diabetes Association: Nutrition, Eating Doesn’t Have to Be Boring

American Heart Association: Healthy Eating

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If you’ve had a heart attack, your doctor has probably prescribed medicines you’ll need to take for a long time. These medicines:

• Help improve blood flow to your heart
• Prevent blood clotting
• Reduce your risk of having more heart problems in the future

Path to improved health

Below is information about medicines that are commonly prescribed to treat heart attack. This includes their benefits, risks, and side effects. If you have questions or concerns about the medicines you’re taking, talk to your doctor.

ACE inhibitors

ACE inhibitors can improve how your heart pumps, making it pump more effectively. This type of medicine improves blood flow by helping to dilate (open) your arteries. It also lowers your blood pressure.

If you have acute coronary syndrome (ACS), your doctor may want you to take an ACE inhibitor. Having ACS means that you have reduced blood flow to the heart. It could be caused by a variety of conditions. One ACE inhibitor might be all the medicine you need. Or your doctor may prescribe one in combination with other medicines. These could include a diuretic or a beta blocker.

Side effects: ACE inhibitors don’t usually cause troublesome side effects. The most common side effect is a dry cough. More rare side effects include:

• Dizziness
• Reduced appetite
• Fatigue (feeling out of energy)
• Problems with your kidneys
• An increase in the level of potassium in the blood

Risks: Because ACE inhibitors can cause birth defects, pregnant women shouldn’t take this medicine.

In rare cases, ACE inhibitors can lead to a serious allergic reaction. This reaction can cause swelling in certain areas of the body. It’s more common in black people and people who smoke. It can be life-threatening. You should get immediate medical attention if you experience swelling after taking an ACE inhibitor.

Aspirin

Your doctor may want you to take a low dose of aspirin each day if you have already had a heart attack. Aspirin helps keep your blood from forming clots. Blood clots can clog the arteries that carry blood and oxygen to the heart. Blockages in these arteries increase your risk of having a heart attack or stroke.

Side effects: Common side effects of aspirin include nausea and upset stomach. Rarely, some people feel nervous or have difficulty falling asleep when taking aspirin. Call your doctor if your symptoms are bothersome.

Risks: Aspirin is not for everyone. Aspirin can increase your risk of stomach ulcers. It can also cause bleeding in your stomach and intestines. Doctors prescribe a low dose of aspirin for people who have ACS. The dosage is usually between 81 and 162 mg per day. The low dose provides the same benefits as a higher dose. But there is less risk of internal bleeding.

Talk to your doctor about the risks and benefits of aspirin therapy. They will prescribe the aspirin dose that’s right for you and tell you how to take it.

Beta blockers

Beta blockers lower the heart rate and blood pressure. They help improve blood flow to the heart, reduce chest pain, and prevent more damage to the heart. Your doctor may want you to take a beta blocker alone. Or they may want you to take it in combination with other medicines. These could include a diuretic or an ACE inhibitor.

Side effects: The side effects of beta blockers tend to be mild. Common side effects include cold hands, fatigue, dizziness, and weakness. Less common side effects include shortness of breath, difficulty sleeping, depression, and decreased sex drive.

Risks: Not all beta blockers are safe for people. Beta blockers are not recommended for people who have asthma. This type of medicine can trigger severe asthma attacks.

Beta blockers may make it difficult for people with diabetes to recognize signs of low blood sugar. One of these signs is rapid heartbeat. If you have diabetes, your doctor will probably tell you to check your blood sugar often.

Stopping beta blockers abruptly increases the risk of heart problems. If you need to stop taking a beta blocker, it’s important to stop gradually. Follow your doctor’s instructions carefully.

Antiplatelets

Antiplatelet medicines help prevent blood clots. They don’t allow certain cells in the blood (called platelets) to clump together. This reduces the risk of blockages in the coronary arteries that can lead to heart attack and stroke. They’re sometimes prescribed along with aspirin therapy.

Side effects: Some common side effects of antiplatelet medicines include:

• Nausea
• Upset stomach
• Stomach pain
• Diarrhea
• Itching
• Rash

Talk to your doctor if you experience side effects while taking this medicine.

Risks: Because antiplatelet drugs prevent blood clotting, they can increase the risk of serious bleeding in some people.

Diuretics

Diuretics (water pills) help the body get rid of extra sodium (salt) and fluid. They reduce the amount of fluid flowing through your blood vessels. This lowers your blood pressure. Diuretics are commonly prescribed to treat high blood pressure. They are sometimes used in combination with beta blockers and ACE inhibitors.

Side effects: Common side effects of diuretics include:

• Increased urination
• Increased thirst
• Fatigue
• Muscle cramps
• Low blood pressure

Less common side effects include increased blood sugar, increased cholesterol, irregular menstrual periods in women, and impotence in men.

Risks: People who take diuretics can have too much or too little potassium in their blood. This depends on the type of diuretic they take.

Statins

Statins are used to lower “bad” cholesterol (LDL) levels. They may also help increase “good” cholesterol (HDL) levels. Most people who take statins will take this type of medicine for the rest of their lives.

Side effects: Muscle pain is the most common side effect of statins. The pain can be mild or severe. Less common side effects include nausea, diarrhea, gas, and constipation. People who take statins may also get a rash. This side effect is more common when a statin is taken in combination with niacin. This is another medicine used to lower cholesterol levels.

You’re at higher risk of having side effects from statins if you:

• Are a woman
• Are age 65 or older
• Have liver or kidney disease
• Have type 1 or type 2 diabetes
• Take several types of medicine

Some people may feel discouraged by the side effects caused by statins. However, the side effects are not usually life-threatening. Your doctor can help you find ways to manage them. If you’re worried about side effects, talk to your doctor about the risks and benefits of taking statins.

Risks: In some people, statins can cause liver damage.

Anticoagulants (blood thinners)

Blood thinners don’t actually thin the blood. They decrease the ability of the blood to clot. This helps prevent clots from forming in the blood vessels. It also may prevent clots from becoming larger. Large clots can cause more serious problems.

Side Effects: The most significant side effect of blood thinners is bleeding. Your blood doesn’t clot as easily. If you cut or injure yourself, you’ll bleed more than normal. The risk of bleeding being a major event is low.

Blood thinners can cause interactions. These could be with some foods, prescription medicines, or over-the-counter supplements. Less serious side effects include:

• Swelling at the injection site
• Diarrhea, vomiting, or inability to eat
• Fever
• Heavier than normal menstrual periods or bleeding between periods

Risks: Some people who take blood thinners are more at risk of having bleeding problems. These include people who:

• Are older than 75
• Take other blood-thinning medicines
• Have high blood pressure
• Have cancer
• Have problems with their kidneys or liver

Be sure to tell your doctor about any other medicines or supplements you take. Tell other health care providers that you are taking a blood thinner.

Things to consider

All medicines can cause side effects. They also can carry risks for certain people. Always tell your doctor about any medicines you take. Tell them about any side effects you’re experiencing. Make sure they know your full medical history so they can prescribe the best medicine for you.

Questions to ask your doctor

• What is the best medicine for me?
• Should I take more than one medicine after having a heart attack?
• Am I at risk for complications from any of these medicines?
• What types of side effects can I expect from the medicines you are prescribing?

Resources

National Heart, Lung, and Blood Institute: Heart Attack

National Institutes of Health, MedlinePlus: Heart Attack

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