When to Prescribe Cardioprotective Drugs in Addition to Those Used to Treat Blood Pressure, Lipids and Diabetes?
• Aspirin for virtually all with established CVD, and in persons at >10% SCORE risk once blood pressure has been controlled. • Beta-blockers after myocardial infarction and, in carefully titrated doses, in those with heart failure. • ACE inhibitors in those with left ventricular dysfunction and in diabetic subjects with hypertension or nephropathy. • Anticoagulants in those at increased risk of thromboembolic events, particularly atrial fibrillation. In addition to drugs to control symptoms, manage blood pressure, lipids and glucose levels to goal, the use or prophylactic drugs shown in clinical trials to reduce CVD morbidity and mortality must be considered. While some of these drugs are appropriate for all individuals at high total risk, whether from established CVD or at high risk of developing CVD, others are specifically indicated for selected patients. Antiplatelet Therapies Patients with Atherosclerotic Disease Aspirin or other platelet modifying drugs are recommended in all pat
