Cardiovascular Diseases Treated With Drugs – Cardiovascular Pharmacology

00:08 We are going to discuss cardiovascular pharmacology in this component and also in the next. Not all cardiovascular drugs will be discussed, of course, because there’s a huge array of them. But we’re going to talk about the major drugs that are used every day for patients with a variety of heart diseases.

00:29 First of all, it’s important to understand which diseases one would treat with various drugs. What are the diseases that we are going to be talking about later in much more detail? The commonest heart diseases are high blood pressure or hypertension, coronary artery disease, heart failure and cardiac arrhythmias - in other words, electrical short circuits or abnormalities in the heart. The drugs that we are going to be discussing can be used for each of these indications and we are going to go through three drug or three classes of drugs.

01:07 Now, it’s important to understand that with drugs, there is not one effect from the drug. In fact, drugs have many effects. Unfortunately, some of those effects are very unpleasant and they vary from person to person. So, let’s take a theoretical example - you have Drug A. You give it to a patient to lower the blood pressure. Wonderful! The blood pressure comes down. But, unfortunately, the drug upsets the patient’s stomach, so that every time the patient thinks about eating, they get nauseous. Well clearly, that’s not a good drug for that patient. Now, it turns out that there are many drugs for high blood pressure. So fortunately, we usually can try others in order to find one that will both take the patient’s blood pressure down and not cause indigestion or another side effect. But, since the drugs work on all tissues, there’s always the potential for side effects and the side effects can sometimes be quite serious. They can cause renal damage. They can cause damage to the blood cells. And so, one has to be very careful about drugs, particularly when you combine them. That’s definitely a chance for interactions that could lead to problems. And in fact, very often, these days with very complicated patients, we often have a clinical pharmacist who makes rounds with us in the hospital and makes suggestions about what drug interactions to avoid and the drugs that will most likely improve the patient without causing a lot of side effects.

02:52 Now, the commonest disease in the world is coronary artery disease. It is the number one cause for death, not just in North America, not just in Western Europe, but throughout the world. It has now moved into the infamous number one place as the biggest killer of human beings in the world. There are a number of related diseases that increase the risk that one might develop coronary artery disease. For example, hypertension - high blood pressure or hyperlipidemia - elevated levels of cholesterol and other fats in the blood which speed or initiate the atherosclerotic, or hardening of the arteries process. So here, you just see the number of millions of people who died on the different continents from arteriosclerotic heart disease.