Heart failure is a condition where the heart cannot pump enough blood to meet the needs of the body’s organs.

People with heart failure may experience symptoms such as difficulty breathing and fatigue.

While doctors cannot cure the condition, different classes of heart medications and lifestyle changes may allow individuals to live a full and enjoyable life.

This article explores various heart failure medications a doctor may prescribe.

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Angiotensin-converting enzyme (ACE) inhibitors help treat heart failure by decreasing afterload, which is the pressure that the heart must exert to eject blood. Side effects of ACE inhibitors include dry cough and increased fluid buildup or edema.

ACE inhibitors work on the renin-angiotensin-aldosterone system (RAAS) in the kidneys. By blocking angiotensin, this drug class:

  • lowers blood pressure
  • prevents remodeling of smooth muscle and heart cells
  • improves the removal of salt

ACE inhibitors include:

  • captopril (Capoten)
  • enalapril (Vasotec)
  • fosinopril (Monopril)
  • lisinopril (Zestril)
  • perindopril (Coversyl)
  • quinapril (Accupril).
  • ramipril (Altace)
  • trandolapril (Mavik)

On April 22, 2022, Pfizer issued a voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake (ADI) as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.

African Americans taking ACE inhibitors have a higher rate of edema when taking ACE inhibitors.

Angiotensin receptor blockers (ARBs) also act on the RAAS. These drugs target the angiotensin receptor, which prevents angiotensin II from activating the RAAS. This blockade has similar effects as ACE inhibitors and reduces death and disability from heart failure.

ARBs are less likely to cause dry cough and edema. However, they can be dangerous for people with kidney problems or low blood pressure.

Examples of ARBs include:

  • candesartan (Atacand)
  • losartan (Cozaar)
  • valsartan (Diovan)

Angiotensin receptor neprilysin inhibitors (ARNIs) include only one medication called sacubitril (Entresto), which is available in a combination pill with valsartan. This class of drugs also acts on the RAAS. Neprilysin acts on the RAAS by promoting salt retention in the body.

By blocking neprilysin, ARNIs allow the kidneys to release salt. ARNIs also block the breakdown of angiotensin II, so people must take them with an ARB.

Some side effects of ARNIs include:

  • low blood pressure
  • increased potassium levels
  • kidney failure
  • cough
  • edema

Taking ARNIs may reduce heart death and the rates of hospitalization for heart failure.

If channel blockers block the funny current in the sinoatrial node of the heart’s right atrium, which initiates the heartbeat. By blocking the current in the sinoatrial node, If channel blockers can slow down the heartbeat, exerting less action on the heart muscle.

If channel blockers include only one drug: ivabradine (Corlanor). This medication can also reduce hospitalization for heart failure. The most important side effects include:

Beta-blockers, or beta-adrenergic blocking agents (BABAs), slow a person’s heart rate. Since many different body cells have beta receptors, this drug class has many side effects, including:

  • low heart rate
  • low blood pressure
  • fatigue
  • dizziness
  • nausea
  • constipation

BABAs that doctors use for heart failure treatment include:

  • bisoprolol (Monocor)
  • carvedilol and controlled release carvedilol (Coreg)
  • extended or controlled release metoprolol succinate (Lopressor)

Using these beta-blockers can lower the risk of death in people with stable heart failure.

A loop diuretic is a type of diuretic that doctors commonly use to treat heart failure. Doctors prescribe them to reduce fluid buildup that may have links with heart failure. One example of loop diuretic includes furosemide (Lasix).

Most side effects due to loop diuretics occur from a loss of electrolytes. People may develop low sodium, potassium, chlorine, and magnesium. Other side effects include skin sensitivity to the sun, ringing in the ears, and gout.

Hydralazine and isosorbide dinitrate are particularly effective for African American people with heart failure. Typically, individuals take this drug along with other heart medications to treat the condition. However, experts do not know how hydralazine and isosorbide dinitrate work to improve heart failure symptoms.

The most common side effects of this drug include dizziness and headaches.

In addition to heart medications, some people may require other drugs to reduce strain on the heart and blood vessels. For example, a person with heart failure and arrhythmia may need an anticoagulant, such as warfarin (Coumadin), or blood thinners, such as aspirin, to prevent blood clots.

Sometimes, people with heart failure may also have high cholesterol and require cholesterol-lowering medications such as atorvastatin (Lipitor).

Other drugs that doctors may prescribe for heart failure include digoxin and aldosterone antagonists.

Digoxin (Lanoxin) is a drug that:

  • increases the force and speed of heart contractions
  • slows the heart rate
  • slows down activity in the atrioventricular node, which allows the ventricles to fill
  • reduces activity in the sympathetic or fight or flight response and the renin-angiotensin system

Aldosterone antagonists are another class of medication that healthcare professionals use to treat heart failure. They also act on the RAAS.

Heart failure is a long-lasting disorder that causes the heart to pump out blood inefficiently. When this occurs, the body organs can become starved of oxygen and essential nutrients. Over time, the condition becomes irreversible and progressively gets worse.

As heart failure progresses, a person may start to have symptoms including:

  • shortness of breath
  • persistent coughing or wheezing
  • fluid accumulation in the feet, ankles, legs, or abdomen
  • weight gain from fluid accumulation
  • pain in the belly
  • fatigue
  • weakness
  • increased heart rate
  • confusion
  • lack of appetite
  • nausea

Doctors have identified several causes of heart failure. Disorders that affect any part of the heart may lead to the condition, including issues with the heart valves.

Potential causes may include:

  • high blood pressure
  • pregnancy
  • anemia
  • high levels of thyroid hormone or hyperthyroidism
  • coronary heart disease
  • cardiomyopathy
  • multiple myeloma

While heart failure is irreversible, doctors can prescribe different medications to help people manage and live with this health issue.

Treatment plans include a combination of different heart drug classes, lifestyle changes, and medical devices or surgeries.

Lifestyle changes that may help reduce symptoms of heart failure include:

  • maintaining a moderate weight
  • tracking daily fluid intake
  • quitting smoking
  • avoiding or limiting alcohol
  • avoiding or limiting caffeine
  • eating heart-healthy foods
  • being active, including sexually active
  • managing stress
  • monitoring blood pressure
  • getting vaccinated against the flu and pneumonia
  • choosing loose-fitting socks and dressing in layers

Maintaining a moderate weight is also important, as it can help a person detect changes in their condition easily. People who gain 3 or more pounds in a day or 5 or more pounds in a week may have worsening heart failure.

Additionally, eating a heart-healthy diet may help slow down heart failure progression. Individuals may also wish to avoid or limit their consumption of:

  • saturated fats
  • trans fats
  • cholesterol
  • sodium
  • red meat
  • sweets

A person can still engage in physical activity and sex if they have heart failure. However, certain adjustments are necessary to reduce stress and strain on the heart. Doctors can help provide people with appropriate guidelines.

While some lifestyle changes are easier to implement than others, adopting appropriate habits can drastically improve a person’s quality of life when living with heart failure.

Heart failure is a long-lasting and progressive condition that causes the heart to pump blood inefficiently. While this disease does not have a cure, doctors can recommend treatment plans depending on the type, class, and severity of heart failure.

People can live full lives by following treatment plans that may include a variety of medications and lifestyle changes.