Watch a string of commercials or page through a magazine, and you’re bound to see at least a couple ads for drugs that promise to protect your heart.
You can probably rattle off a bunch of names—Plavix, Lipitor, and Coumadin, for starters—and you may even have a bottle or two sitting in your medicine cabinet.
After all, 30 percent of U.S. adults have high blood pressure, and 13 percent have high cholesterol, according to the Centers for Disease Control and Prevention.
But how exactly do these common drugs reduce your risk of stroke, heart attack, and other heart problems?
Read on to find out what you need to know about some of the most commonly prescribed pills.
You know them as: Aspirin, Coumadin, and Plavix
Anticoagulants are known as blood thinners, but they don’t actually thin your blood.
What they do is interfere with proteins in your body called clotting factors, which help produce clots. These clots can be harmful because they block blood flow in your arteries.
“Heart attacks and stroke are caused by a blockage in blood flow to either the heart or the brain,” says Allan Stewart, M.D., director of aortic surgery and co-director of the Valve Center at The Mount Sinai Health System, in New York City.
Your doctor may prescribe an anticoagulant if you have a history of a heart condition such as heart attack or atrial fibrillation—an irregular heartbeat—or have risk factors for heart disease.
These include being obese or diabetic, smoking, or having a family history of heart disease or heart attack.
Type: ACE inhibitors
You know them as: Zestril, Lotensin, or Monopril
ACE inhibitors—officially known as angiotensin converting enzyme inhibitors—are drugs used to treat high blood pressure.
Your doctor may prescribe blood pressure medications like ACE inhibitors if your systolic pressure (the top number) is 140 or higher, or your diastolic pressure (the bottom number) is 90 or higher, and lifestyle modifications such as exercise and eating a healthier diet have failed.
ACE inhibitors work by slowing down the activity of a blood vessel-constricting chemical in your body called angiotensin II. This allows your blood vessels to dilate, bringing down your blood pressure.
After starting you on ACE inhibitors, your doctor will monitor you to make sure the medication is lowering your BP without causing any significant side effects like headache, dizziness, or fatigue.
About 20 percent of patients also experience a dry, hacking cough on the meds, since ACE inhibitors may irritate nerve fibers in your trachea, according to researchers in the Netherlands.
If you are experiencing side effects, your doctor will switch you to another blood pressure medication.
There are over 100 medications designed to lower your BP, says Dr. Stewart—and finding the one that works best for you can be a trial-and-error approach.
You know them as: Atacand, Avapro, or Benicar
ARBs—angiotensin II receptor blockers—are another class of drugs used to treat high blood pressure.
Like ACE inhibitors, ARBs target the protein angiotensin II, which constricts your blood vessels. It just does so in a different way, by preventing the protein from binding to its receptors on your muscles and around your blood vessels.
As a result, your vessels dilate, allowing blood to flow more freely and bring down your BP.
ARBs are often prescribed for people who experience the hacking cough associated with ACE inhibitors, since this drug is much less likely to cause that side effect, Dr. Stewart says.
Still, they aren’t without their own host of side effects, including diarrhea, muscle cramps, insomnia, and irregular heart rate.
If you’re bothered by side effects, your doctor will switch you to another BP-lowering drug.
You know them as: Metoprolol, Tenormin, or Lopressor
Prescribed to reduce high blood pressure, beta-blockers work by blocking the effects of the hormone epinephrine. Doing so brings down your heart rate.
“A slower heart rate means your heart has more time to fill with blood, which may reduce your blood pressure,” Dr. Stewart says.
While beta-blockers are very effective at bringing down your BP, they can also bring you down in the bedroom. That’s because they may interfere with a part of your body’s nervous system responsible for causing an erection, he says.
If the issue occurs, continue taking your meds, but discuss the problem with your doctor.
He or she may switch you to a script that’s less likely to cause the problem, such as ACE inhibitors, which help dilate blood vessels so more blood can flow through them.
Your doctor might also add an erectile dysf unction drug like Viagra or Cialis, but only if your BP remains well-controlled on your BP meds.
That’s because combining the two meds can cause a dangerous drop in your blood pressure, so your doctor will need to make sure your BP isn’t dipping too low on your meds.
You know them as: Lipitor, Zocor, or Crestor
Statins block an enzyme called HMG-CoA reductase, which is involved in cholesterol production in your liver.
That’s important, since too much cholesterol can be detrimental on your arteries. Ideal total levels should be below 200 milligrams per deciliter (mg/dL), and LDL, or “bad” cholesterol, under 100 mg/dL.
Over time, as cholesterol builds up, your arteries narrow and stiffen—a condition known as atherosclerosis.
This slows blood flow to your heart and can cause chest pain. Even worse, your arteries can get so stuffed with plaque that blood flow blocks completely, and you suffer a heart attack.
If you’re diagnosed with high cholesterol, you might not be prescribed a statin right off the bat: Doctors like to give patients a shot controlling it with diet first, Dr. Stewart says.
This means cutting back on fried foods, fatty red meat, high fat dairy, and foods made with trans fats, while upping your fruit, vegetable, lean protein, low-fat dairy, and fish intake.
If your levels still don’t drop into the healthy range, then your doctor may start you on a statin to reduce it further.
You’ll likely also get a prescription as a precaution if you’ve already had a heart attack or bypass surgery, he says.
You know them as: Nitrostat
Nitrates, a type of vasodilator, used to be prescribed more frequently as a BP-lowering medication, but now they’re mostly used for people with chest pain or in those having a heart attack, Dr. Stewart says.
They’re short-acting drugs that work quickly to relax the smooth muscle in blood vessels, so they can expand and blood can flow more freely.
Like other BP-lowering drugs, vasodilators can cause headaches, dizziness, rapid heartbeat, and flushing.
Tell your doctor if you’re taking any supplements or drugs for erectile dysfunction, since combining them with vasodilators can cause a severe drop in blood pressure.
You know them as: Lozol, Microzide, or Thalitone
Diuretics are known as water pills because they help flush fluids out of your body through your pee.
This actually helps lower your blood pressure: Less fluid in your body means lower blood volume, so your heart doesn’t have to work as hard to pump blood through your body, Dr. Stewart says.
If you have congestive heart failure, your doctor may also prescribe a diuretic to help with swelling—officially known as edema—which occurs when your heart isn’t pumping as well as it could and fluids get backed up.
Of course, a major downside of taking diuretics is frequent urination, which can last up to several hours after downing a dose.
And if you lose too much fluid, you can experience dehydration. Signs include faintness, thirst, dry mouth, straw-colored urine, or constipation.
Staying hydrated is key, but still contact your doctor if you notice any of these symptoms. He or she may switch you to another BP-lowering medication.