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Pharmacology of the Cardiovascular System

Instructor: Erika Pearce

Erika is an registered nurse who has taught licensed practical nursing courses and is currently in her 3rd year of medical school

A healthy cardiovascular system is essential to overall health and wellness. This lesson outlines some of the most common cardiovascular disorders and the medications used to manage them.

Overview of the Cardiovascular System

The cardiovascular system is the railway system of the body. It transports nutrients to all the organs and tissues to keep them supplied with energy in much the same way trains transport supplies across the country. When this system shuts down, the organs and tissues begin to starve. This can occur when the vessels that transport the nutrients get clogged and the blood can't get through, or when the heart stops pumping properly and is no longer able to provide enough force to push the blood through this intricate network of vessels. There are many things we can do as individuals to keep this railway system working at its best including eating properly, avoiding smoking, and exercising regularly, but sometimes that just is not enough. For many people, medications are necessary to prevent the cardiovascular system from backing up or shutting down all together.

cardiovascular system

Common Cardiovascular Issues and Treatments

Atherosclerosis

What is it?

The most common cause of cardiovascular shut down is the buildup of cholesterol in the blood vessels, called atherosclerosis. Over a long period of time, cholesterol is deposited into the walls of the blood vessels causing blockages that prevent adequate blood flow downstream. The coronary arteries, the ones that feed the heart itself, are particularly prone to blockage by cholesterol plaques. When these vessels become blocked and there is no oxygen getting through, the heart muscle becomes damaged and can potentially die.

Atherosclerosis

Treatment

The most commonly used medications to reduce cholesterol are called statins (eg. atorvastatin). These medications block the enzyme in the liver that is necessary for the body to create cholesterol.

Hypertension

What is it?

Another very common underlying cause of heart disease is hypertension (high blood pressure), which affects approximately 75 million American adults. When the heart has to pump against a high pressure, it requires more oxygen to function meaning greater risk of damage to the heart muscle due to ischemia (inadequate oxygenation).

Complication of Hypertension
atherosclerotic plaques

Treatment

Usually the first medication prescribed for hypertension, a thiazide diuretic (eg. hydrochlorothiazide), often referred to as a water pill, works on the kidneys and makes you pee. This decreases overall blood volume, thereby reducing the pressure on the blood vessels. Angiotensin converting enzyme inhibitors (ACEIs) (eg. lisinopril) and angiotensin II receptor blockers (ARBs) (eg. losartan) prevent vasoconstriction (narrowing of the blood vessels) and fluid retention to lower blood pressure. Other blood pressure medications, such as beta-blockers (eg. metoprolol) slows the heart and reduces the force of its contractions while dihydropyridine calcium channel blockers (eg. amlodipine) lower pressure by dilating coronary and systemic arteries. The type of antihypertensive medication prescribed to an individual will depend on other health problems and risk factors.

Angina

What is it?

Even when we try to control hypertension and high cholesterol, sometimes it is not enough and the heart still cannot get enough oxygen. This can cause a chronic reversible problem, such as with angina, or it can involve permanent damage to part of the heart muscle, such as with a heart attack, or myocardial infarction (MI).

Treatment

In both angina and MI, opening up the blood vessels lowers blood pressure and decreases the oxygen demands of the heart, reducing the damage to the muscle. This can be accomplished by the use of nitroglycerin. These medications come in fast acting formulas that are absorbed under the tongue which can be used for quick relief of pain or in slow release patches or pills for those with chronic symptoms.

Arrhythmia

What is it?

Sometimes all this heart strain can cause the electrical conduction system in the heart to malfunction. There are many different causes and types of arrhythmias (irregular heartbeats), all indicating, to varying degrees, that the heart is not performing at its best. When the pumping of the heart is uncoordinated or too fast the heart cannot fill properly and not enough oxygen-rich blood can make it to its final destination.

Stroke

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