The purpose of your heart medications is (1) to help you live longer, (2) to improve your heart muscle function and reduce the stress on your heart, and (3) to help you feel better. The key aspect to helping you feel better is to improve your heart muscle function, and that also is the most important determinant of helping you live longer. In most cases, medications to improve heart muscle function are started at low doses and are increased over time.
ACE Inhibitors Angiotensin-converting enzyme inhibitor/angiotensin blockers (ACEI/ARB) are heart medications that help your heart muscle get stronger. They also widen, or dilate, your blood vessels. That increases the amount of blood your heart pumps and lowers blood pressure. They also raise blood flow, which helps to lower your heart’s workload.
Beta blockers Beta blockers, also known as beta-adrenergic blocking agents, are medications that improve your heart muscle function, sometimes to near normal levels. They work by blocking the effects of the hormone epinephrine, also known as adrenaline, which lets your heart muscle become healthier. They may also tend to reduce your blood pressure, which if elevated, is another beneficial effect.
ARNIs Angiotensin Receptor-Neprilysin Inhibitors represent a newer category of medications for DCM. ARNIs are a combination of an ARB and a drug called Sacubitril. Like ACEI, ARBs, and Beta Blockers, ARNIs help improve the heart muscle function and improve survival. Neprilysin inhibitors are drugs that prevent the breakdown of an important and helpful hormone that combats the symptoms and effects of congestive heart failure. ARNIs combine the beneficial effects of the ARB and the Neprilysin inhibitor. The drug Entresto is a combination medication that falls into this category.
ADJUSTING TO A NEW MEDICATION
Your DCM did not begin immediately, but took some time to develop, and medications to treat DCM usually take time to work.
Your doctor may change your medications or the amount of current medications for several reasons. As noted above, new medications may be started at very low doses and the dose may need to be increased over time. Other reasons include the effectiveness of the medication, a change in your condition, or in some cases the cost of the medication. As each patient is unique, the reasons for changing medications are usually specific to the individual, so you must ask your doctor why there is a change in your medication.
MEDICATION SIDE EFFECTS
All medications have side effects. Some you may experience, some perhaps not. So, when beginning or changing the dose of a current medication, you may feel side effects. In every case, any concerns about the medication or the side effects of medications should be discussed with your doctor.
Every medication has side effects. YOU must read the labels on the medication. Labels are provided on each medication for YOUR benefit. Ask your doctor what to look for, and when to call him/her or their office when side effects become pronounced.