Patient Education & Resources

Have You Taken Your LIFESAVERS Today?

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Certain kinds of medication should be used for all patients with vascular disease. These types of medications are used to prevent worsening of disease that is already present, or progression of disease not yet detected. The drugs listed below are known as the "Lifesavers" because all of these types of drugs have been proven to save lives.

1. Blood "Thinners":
   ASA (aspirin), clopidogrel (Plavix), aggrenox (ASA & dipyridamole) and warfarin (Coumadin) are drugs used to "thin' the blood. Aspirin is most often used. Platelets are a kind of blood cell that make your blood clot. Aspirin works by making the platelets less likely to clot. As a result, there is less chance that you will form a clot in your arteries. This reduces the chance of unstable angina, heart attack, stroke, and sudden death. Coumadin is a more powerful blood thinner, and may be used in special circumstances. Usually, you will not be on both Coumadin and another blood "thinner" together, but occasionally they are used in combination.


2. Beta Blockers:
   There are many kinds of Beta Blockers, but all of the names end in "lol". A few examples are metoprolol (Betaloc,Lopresor), sotalol (Sotacor), bisoprolol (monocor) atenolol (Tenormin), and carvedilol (Coreg). It is very important to know if you are on a beta blocker. These drugs help prevent another heart attack, reduce or prevent angina (chest pain), and some also help to prevent abnormal heart rhythms. Almost all heart attack patients should be on a beta blocker. Patients with heart failure or damaged heart muscle also benefit from beta blockers. People with asthma or diabetes may not be able to take beta blockers.


3. ACE Inhibitors and ARBs:
   There are many kinds of ACE Inhibitors, but all of the names end in "PRIL". A few examples are ramipril (Altace), perindopril (Coversyl), lisinopril (Zestril, Prinivil), and enalapril (Vasotec).In the past, these drugs were mostly used to lower blood pressure. Today, ACE Inhibitors also appear to save lives in people who have any kind of vascular disease and especially in patients who also have diabetes. They help to protect the walls of all of the blood vessels in your body, and in doing that, they protect against heart attack, stroke and death. They are used extensively in heart failure. A related class of drugs, ARB’s, (drugs that end in "SARTAN") appear to have similar benefit. Examples of these are candesartan (Atacand), valsartan (Diovan), eprosartan (Teveten), irbesartan (Avapro), telmisartan (Micardis), and the original in the class, losartan (Cozaar).


4. Cholesterol/Triglyceride Drugs:
   Most common are STATINS. A few examples are rosuvastatin (Crestor), atorvastatin (Lipitor), simvastatin (Zocor). There are other statins available, but it is uncommon to achieve the current cholesterol goals with these agents. They lower cholesterol very well and are extremely well tolerated. Alternatives (especially for those patients with high triglycerides) are a class of drugs known as FIBRATES. Examples are fenofibrate (Lipidil), bezafibrate (Bezalip) and gemfibrozil (Lopid). Diet plays an important role but the drugs are essential in most patients - even those with "normal" cholesterol.

Vascular disease is the term to describe narrowed or damaged arteries. It is the condition that leads to stroke, heart attack, kidney failure, aneurysms, blocked vessels in the legs, and is the major cause of death in Canada. It is a "systemic disorder" - that means if you have it anywhere, you have it, at least to some extent, everywhere. Being diabetic is the same as having established vascular disease. In addition to drugs, here are some things you can do to help. Best results are obtained using both drugs and lifestyle changes.

Smoking: The single biggest risk factor, that is totally within your control, is smoking. There is some good news: vascular disease patients who quit smoking will, within 2 years, reduce their risks to be equivalent to someone who has never smoked. Resources to help you: Public Health Units, Heart and Stroke Foundation, Lung Association, Health Canada, adjunctive therapy like hypnosis and acupuncture as well as specific medications that your doctor can prescribe to assist you in quitting.

Diet: Being overweight is a risk factor and makes it harder to exercise. Eating a healthy diet, limiting refined sugars and replacing them with complex carbohydrates (whole grain high fibre), plenty of fruits and vegetables and some lean protein can go a long way to help you with weight control. You will also feel more energetic, more successful and more motivated to take on other challenges - like stopping smoking.Resources to help you:Heart and Stroke Foundation, cardiac rehabilitation programmes in your area, local health unit programmes and local dieticians.

Alcohol: It is true that small doses of alcohol may actually be good for your heart (observe the restrictions on your medication bottles - alcohol should not be used at all if you are on certain drugs). It is not true that more alcohol is better. More than one drink a day for females and two drinks a day for males is likely to be harmful to your overall health. It is also a good idea to take a day off alcohol at least one day per week. If someone in your family or a close friend thinks you have a drinking problem, they are probably right. Resources to help you: Alcoholics Anonymous. FOURCAST.

Exercise: The benefits of regular exercise cannot be overstated. Weight control, improved energy, reduced depression, better fitness and reduced risk for serious cardiovascular events are among the long list of good outcomes. It does not have to be vigorous high level exercise, but it does have to be sustained and regular. Ideally, 30 - 60 minutes 5-7 times per week. Even if you just walk for that period of time, you will enjoy major benefits. Start slowly. A few minutes a day is a good start. There is no age limit. And yes, even the oldsters can benefit from lifting light toning weights. Strength training helps improve your ability to get around and will reduce your chances of falls and broken bones. Resources to help you: Public Health Units, Heart and Stroke Foundation, cardiac rehab facilities and local gyms/health clubs.