Dr. Garvanski, we Bulgarians are known for prescribing our own medicines. Are there risks to taking medications that are not prescribed by a specialist in people who have cardiovascular diseases?
- For people suffering from heart problems, it is especially important to be informed about the risks of taking certain medications. If you are a patient with a heart problem, be sure to first discuss with your cardiologist all medications and nutritional supplements you are taking.
What are these medications to which such patients should be especially careful?
- There are four categories of medications that are risky in terms of cardiovascular disease. First of all, these are over-the-counter pain relievers.
What exactly are these painkillers?
- There are several types of over-the-counter pain relievers, such as: acetaminophen and non-steroidal anti-inflammatory drugs. Examples of the second type are: ibuprofen and naproxen sodium. Anti-inflammatory drugs, especially when taken in high doses, can raise blood pressure, thereby increasing the risk of heart attack or stroke.
Does this mean that people with high blood pressure should not take pain medication?
- No, of course. But if you take prescription medication for high blood pressure or have a heart problem, be sure to talk to your cardiologist, who will help you find a pain reliever that's right for you.
Now is the period when viruses and flu are around. We have to take medicine to relieve the symptoms. Are there any among them that can complicate the condition of people with heart problems?
- Many cold, flu or allergy medications include decongestants that can
cause blood pressure to rise
or affect the effectiveness of some prescription drugs. Do not take decongestants if you have high blood pressure, are taking medication for hypertension, or have heart problems. An example of a decongestant is pseudoephedrine, xylometazoline, etc.
What is the other group of risky medications?
- The other risk group includes some antibiotics. Azithromycin, for example, is an antibiotic commonly used to treat bacterial infections. It is sold under the name azitrol and azitrox. A recent study indicates that azithromycin can cause changes in the heart's electrical system, which in turn can lead to arrhythmia, or a fast heartbeat. Patients at risk of developing such conditions are those with risk factors such as QT interval, low levels of potassium and magnesium, lower than normal heart rhythm, use of certain arrhythmia medications or heart rhythm disorders. The Medicines Agency states that antibiotics of the same class, such as azithromycin, called macrolide groups, have the same side effects. We advise you to discuss any concerns about this type of antibiotic with your cardiologist.
We consider plant-based nutritional supplements to be completely safe. Is that so?
- Herbal supplements appear natural and harmless, but unlike conventional medications, herbal supplements do not go through rigorous clinical trials. Some serious reported
drug and herbal supplement interactions
which have not been researched. Some herbal and herbal preparations, for example, can cause heart and vascular problems - they can affect blood pressure and heart rhythm, regardless of whether you are taking any medications for cardiovascular disease. Therefore, it is always necessary to discuss this with your doctor before taking any plant-based nutritional supplements.
What should we do before we start taking a new medication or nutritional supplement so we don't harm ourselves?
- When you look at the label of any medication, carefully read the list of active and inactive ingredients it contains. Many medications are high in sodium, which raises blood pressure. If something worries you, ask the pharmacist at the pharmacy. He can always tell you if certain pain relievers are compatible with certain medical conditions or drug therapy. In addition, he can offer you an alternative substitute. Most importantly, if you are a patient with cardiovascular disease, remember to discuss all medications and nutritional supplements you plan to take with your cardiologist.