What if you've conscientiously adopted the proper lifestyle measures but haven't made enough progress in controlling your cholesterol levels or blood pressure? Although these lifestyle approaches are an important first step in preventing a heart attack, some people need more.
If you don't see adequate improvements in your lipid levels or blood pressure within three months of making lifestyle changes, your doctor may prescribe medication. Some individuals start on medication without this short trial of lifestyle measures, usually because they have dangerously high cholesterol or blood pressure, are at high risk for a heart attack, or already have coronary heart disease.
Do not forget that lifestyle changes are still important even if you are taking medication to improve your cholesterol levels or to reduce your blood pressure. In fact, the combination of medication and lifestyle measures is more effective in preventing heart attacks than medication alone. In addition, including lifestyle measures in your treatment plan may mean that you can take a lower dosage of your medication, which will reduce the chances of side effects.
In May 2014, the U.S. Food and Drug Administration (FDA) approved vorapaxar (Zontivity)the first protease-activated receptor-1 (PAR-1) antagonist (an antiplatelet agent)to reduce the risk for heart attack and stroke in people who have had a previous heart attack or who have peripheral artery disease (PAD; blockages in arteries to the legs). This medication increases the risk for bruising and bleeding, which may be life-threatening or fatal. It should not be used in people who have had a stroke, transient ischemic attack (TIA; mini-stroke), or brain hemorrhage.
Roger S. Blumenthal, M.D.
Director, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease
Professor of Medicine, Johns Hopkins University School of Medicine
Simeon Margolis, M.D., Ph.D.
Professor of Medicine and Biological Chemistry, Johns Hopkins University School of Medicine
Updated by Remedy Health Media