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SGLT2 Inhibitors: How These Medications Are Transforming Heart Failure Care: For Diabetics and Non-Diabetics Alike

It’s not often that a class of medication reshapes how we manage both heart failure and diabetes, but SGLT2 inhibitors have done exactly that. Originally developed to lower blood sugar in people with type …

Abdominal Aortic Aneurysm: What You Need to Know

The aorta is the body’s largest artery, carrying oxygen-rich blood from the heart to the rest of the …

Could Drug-Coated Balloons Replace Permanent Heart Stents?

For decades, heart stents have been the mainstay treatment for coronary artery disease (CAD), restoring blood flow in …

Cardiac Amyloidosis: An Uncommon but Important Cause of a ‘Stiff’ Heart

For years, diagnosing cardiac amyloidosis has been regarded as an academic pursuit in many regions, primarily due to …

What is Atherosclerosis?

Healthy Living

Enjoy the Heart-Healthy Power of Oats

Dietary fiber: Good for your gut, great for your heart

Understanding Cardiovascular Risk Factors

Omega-3 Delight: Heart-Healthy Air Fryer Salmon with Pumpkin Chips and Broccoli

Salmon and Heart Health: A Nutritional Powerhouse

Unlock Heart Health with Omega 3 and 6

Exploring the Anatomy and Physiology of the
Human Heart

A Cheater’s Guide to Saucing: Greek Yogurt

The Mediterranean Diet: A Key to Longevity and Health for Women

Fish Oil Supplements for Heart Health

The Role of CoQ10 and Ubiquinol for Heart Health

Editorial Spotlight

Prof. Peter Barlis - Editor

Prof. Peter Barlis - Editor

Thank you for visiting heartmatters.com. We aim to empower you with valuable, easy-to-understand heart health insights, cutting through jargon. Whether you aim to control your heart health, manage an existing condition, or enhance your knowledge of heart wellness, Heart Matters is your go-to guide to help you achieve your goals.

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Abdominal Aortic Aneurysm: What You Need to Know

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Optimizing Treatment Approaches for Congestive Heart Failure: Quadruple Therapy

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Symptoms
Heartburn or Heart Attack? Differentiating Symptoms for Timely Care

During my follow-up consultations with patients after their discharge from the hospital following treatment for a heart attack, a common theme emerges: many recount initially attributing their chest discomfort to heartburn or indigestion. Often, …

Heartburn or Heart Attack? Differentiating Symptoms for Timely Care

During my follow-up consultations with patients after their discharge from the hospital following treatment for a heart attack, …

Do you have a persisting dry cough? Read on

As a Cardiologist, I frequently hear patients discussing a dry cough – one of the more common symptoms …

Palpitations and Ventricular Ectopics: Causes, Symptoms, and Management

Our heart relies on a precise electrical system to maintain rhythm and function. This system works silently in …

Understanding Dizziness:
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Dizziness is a seemingly innocuous sensation that can leave us disoriented, unsteady, and anxious. While a momentary bout …

Understanding Ankle Swelling (Edema)

Swelling of the ankles, also known as edema, is a common condition that can be caused by a …

Chest Pain: Understanding Symptoms, Causes, and Evaluation

Chest pain is a common symptom that can be concerning, as it is can be associated with heart-related …

Understanding Dizziness:
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Medication Hub

A Guide to Beta-Blockers
The Timing of Cholesterol-Lowering Medications: Does Nighttime Dosing Make a Difference?
Calcium Channel Blockers: Amlodipine, Felodipine, Nifedipine, and More
A Guide to Angiotensin II Receptor Blockers (ARBs) for Heart Health
Optimizing Cholesterol Management: The Role of Ezetimibe

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    Heart Matters, edited by Cardiologist Professor Peter Barlis, is a trusted resource dedicated to providing you with simplified and accurate information about cardiovascular health. It aims to bridge the gap between scientific discoveries and their practical application, empowering you to make informed decisions and promote overall cardiovascular wellness.

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other anti-anginals

When first-line therapies for angina, such as beta blockers, calcium channel blockers, and nitrates, prove inadequate or are not well-tolerated, second-line therapies may be considered.
Perhexiline is a unique medication that enhances the heart's ability to utilize fatty acids for energy, reducing its reliance on oxygen and lowering oxygen demand. This action helps improve blood flow and alleviates chest pain in some patients with refractory angina.
Nicorandil is another second-line option with a dual mechanism of action. It opens potassium channels in smooth muscle cells, causing vasodilation and enhancing coronary blood flow. Additionally, nicorandil also stimulates nitric oxide release, further dilating blood vessels and reducing heart workload.
Trimetazidine is an anti-ischemic agent that improves cardiac efficiency by enhancing glucose metabolism and shifting the heart's energy production to a more oxygen-efficient process. As second-line therapies, these medications offer alternative approaches for managing angina in individuals who do not respond adequately to first-line treatments or those experiencing side effects from other medications.

lipid lowering therapies

Lipid-lowering therapies play a critical role in managing coronary artery disease (CAD), a condition characterized by the narrowing of blood vessels that supply the heart. Among the most commonly discussed and debated classes of medications are statins, which effectively reduce cholesterol levels and are widely prescribed to lower the risk of cardiovascular events. Alongside statins, other medications like ezetimibe, fibrates, and niacin are also utilized to target specific aspects of lipid metabolism, such as cholesterol absorption, triglyceride levels, and raising high-density lipoprotein (HDL) cholesterol. Additionally, the introduction of medications that inhibit PCSK9, an enzyme involved in cholesterol metabolism, has provided a promising new approach to further lower LDL cholesterol levels. These PCSK9 inhibitors, such as Repatha (evolocumab), have shown significant efficacy in reducing LDL cholesterol levels in patients with CAD, especially for those who may not respond well to traditional therapies.

Nitrates

Nitrates are widely used to treat angina and provide quick relief for chest pain. Commonly available in the form of sublingual sprays or tablets, patches, and long-acting tablets, nitrates work by dilating blood vessels, allowing for increased blood flow and reduced resistance. This dilation eases the heart's workload, leading to a decreased demand for oxygen and prompt alleviation of angina symptoms. Sublingual nitrates act rapidly and are often used to provide immediate relief during angina attacks, while patches and long-acting tablets are employed for preventive purposes. However, nitrates may cause side effects such as headaches, dizziness, and flushing, which usually subside over time.

calcium channel blockers

Calcium channel blockers, including amlodipine, felodipine, cardizem (diltiazem), and verapamil, are commonly prescribed for the treatment of angina. These medications work by inhibiting the influx of calcium into the muscle cells of the heart and blood vessels, leading to their relaxation. As a result, blood vessels widen, promoting improved blood flow and reduced blood pressure. In the context of angina, this relaxation decreases the heart's workload, lowering the demand for oxygen and alleviating chest pain. Calcium channel blockers offer a valuable treatment option for individuals with angina, but it is essential to be aware of potential side effects, which may include headaches, dizziness, flushing, and ankle swelling.

Beta blockers

Beta blockers, such as metoprolol, propranolol, atenolol, carvedilol, and bisoprolol, play a crucial role in treating angina. By blocking certain receptors in the heart, they effectively reduce heart rate and the force of contraction, thereby easing the heart's workload. This mechanism of action leads to a decreased demand for oxygen, making beta blockers highly effective in relieving chest pain associated with angina. As with any medication, it's important to consider potential side effects, including tiredness, worsened asthma, erectile dysfunction in some males, and more vivid dreams during sleep. Consult your healthcare provider to determine the suitability of beta blockers for managing your angina and overall heart health.

Anti-platelet Medications

Anti-platelet medications play a crucial role in preventing blood clot formation, reducing the risk of serious cardiovascular events such as heart attacks and strokes. Among the widely used anti-platelet drugs are aspirin, clopidogrel, and ticagrelor.

Aspirin: This well-known medication inhibits platelet activation, making it less likely for platelets to stick together and form clots. Aspirin is commonly used for primary and secondary prevention of heart attacks and strokes.

Clopidogrel: As a potent anti-platelet agent, clopidogrel works by blocking specific receptors on platelets, preventing them from aggregating. It is often prescribed to patients with acute coronary syndrome, those undergoing stent procedures, and for some cases of peripheral arterial disease.

Ticagrelor: Ticagrelor is another effective anti-platelet drug that works by inhibiting platelet activation. It is used in acute coronary syndrome, often given alongside aspirin to reduce the risk of heart-related events.