Heart Medication and Health Risks

drugs 101

  • Introduction to Heart Medications
    • The heart's vital statistics:
    • Pumps approximately 2.6 billion times during a lifetime.
    • Circulates about 5 to 6 liters of blood per minute.
    • Contains around 100,000 km of blood vessels.

Heart Health and Risks

  • Coronary Vessels:

    • These are essential for feeding the heart.

  • Prevalence of Cancer Deaths:

    • Many types of cancer deaths are avoidable, linked to:
    • Tobacco use
    • Diet and obesity
    • Viruses
    • Alcohol
    • Lack of exercise
    • UV radiation
    • Environmental exposure (2-4%)
    • Genetic factors
    • Medical procedures (e.g., X-rays, chemotherapy)

  • Heart Problems:

    • Many deaths from heart diseases are avoidable, often due to:
    • Tobacco
    • Obesity
    • Diet
    • High salt and saturated fat intake
    • Gender predisposition (being male)
    • Stress
    • Inactivity, genetic factors, and infections.

Impact of Smoking on Heart Health

  • How Smoking Affects the Heart:
    • Smoking poisons the heart by:
    • Reducing oxygen delivery, because carbon monoxide (CO) competes with oxygen (O₂) for hemoglobin binding.
    • Resulting oxygen deficiency damages the heart and blood vessels.

Obesity and Heart Disease

  • Obesity's Impact:
    • Leads to increased workloads on the heart, significantly worsening cardiovascular health.

Statistics on Heart Attacks

  • Heart Attack Data:
    • Approximately 1.5 million heart attacks occur annually.
    • Of these:
    • 25% die immediately.
    • 25% are unaware they are at risk.

Dietary Factors Affecting Heart Health

  • Dietary Risks:

    • Problematic substances include high levels of:
    • Fat, sugar, and salt.

  • Healthy Diet:

    • A diet rich in fruits and vegetables is recommended.
    • Variety in diet is essential for optimal health.

  • Overeating:

    • The average North American consumes nearly double what is necessary for health.

Statins - Cholesterol-Lowering Medications

  • Statins:

    • Statins, like Lipitor (atorvastatin calcium), are effective in lowering heart attack risks in individuals with multiple risk factors such as:
    • Family history
    • High blood pressure
    • Advanced age
    • Low HDL (good cholesterol)
    • Smoking history.

  • Clinical Evidence for Statins:

    • In a large clinical study:
    • 3% of those on placebo had a heart attack compared to 2% of those on Lipitor.

  • Gender Differences in Risk:

    • Men have a 10 times higher heart attack risk than women, but risks equalize post-menopause.

Stress and Heart Health

  • Importance of Stress Management:
    • Stress levels are a significant risk factor for heart attacks.

Physical Activity and Heart Protection

  • Exercise:
    • Regular physical activity is known to protect heart health.

Family History's Role

  • Genetic Predisposition:
    • Family history can increase the risk of heart disease, with specific emphasis on:
    • Heart attacks and high blood pressure among relatives.

Infection and Heart Disease

  • Microbial Involvement in Heart Disease:
    • Some microbes linked to heart disease include:
    • Herpes virus
    • Cytomegalovirus
    • Chlamydia pneumoniae
    • Prophyromonas gingivalis.

Heart Function and Abnormalities

  • Cardiac Issues:
    • Potential problems include:
    • Impaired valve functions,
    • Neurological issues affecting heart function,
    • High blood pressure,
    • Poor blood circulation.

Treatment and Surgery Options

  • Surgical Interventions:
    • Some valve functions can be corrected through surgical procedures.

Drugs Affecting Heart Rate

  • Sympathetic and Parasympathetic Nervous System:

    • The sympathetic system stimulates heart rate, which can be modulated by drugs (e.g., beta-blockers).

  • Beta-blockers:

    • These drugs help control heart rates by blocking the effects of norepinephrine, leading to lower heart rates.

Hypertension - The Silent Killer

  • Blood Pressure Measurement:

    • Two pressures are measured:
    • Systolic (normal ~120 mmHg) - pressure when the heart beats.
    • Diastolic (normal ~80 mmHg) - pressure when the heart rests.

  • Hypertension Classifications:

    • Diastolic pressures:
    • < 90 is normal,
    • 90–104 is mild hypertension,
    • 105–115 is moderate,
    • > 115 is severe hypertension, with each 5 mm increase in diastolic pressure raising heart attack risk by 25%.

  • Prevalence of Hypertension:

    • Affects approximately 20% of adults.
    • Classified as primary (essential) or secondary.

Sodium and Heart Health

  • Sodium Intake:

    • Average daily intake for Canadians is 3400 mg, which is more than double the necessary amount (1000-1500 mg recommended).

  • Processed Foods:

    • High sodium levels are common in processed and fast foods.

Congestive Heart Failure (CHF)

  • What is CHF?:

    • Condition where the heart is inefficient at pumping blood, leading to fluid buildup in the body.

  • Causes of CHF:

    • Can arise from several conditions:
    • Coronary artery disease,
    • High blood pressure,
    • Heart valve issues,
    • Heart rhythm disorders.

Digitalis and Heart Medication

  • Digitalis:
    • Extracted from foxglove plant, used to boost heart function and manage fluid retention.
    • Potential risks associated with plant extracts due to overdose possibilities.

Coenzyme Q10 and Heart Supplements

  • Coenzyme Q10:
    • While it has some support for neurological disorders, studies show no significant benefits in improving heart disease outcomes.

Angina Treatment**

  • Angina and Vasodilation:

    • Angina results from impaired blood flow due to vasoconstriction.

  • Nitroglycerin Use:

    • This medication is used sublingually to ease angina symptoms by inducing vasodilation, improving blood flow to the heart.

  • L-Arginine for Angina?:

    • Initially perceived as beneficial, studies reveal no significant improvement for patients with angina; Health Canada advises against its use post-heart attack due to potential risks.