The cardiovascular drugs are drugs that act directly or indirectly on the cardiovascular system. They include antiplatelet agents, antianginal agents, antiarrhythmics, anticoagulants, antihypertensives, diuretics, fibrinolytic, cardiac stimulants, lipid lowering agents, vasoactive agents, and antiatherosclerotic agents.


  • Antiplatelet agents: anti-platelet drugs are able to prevent the aggregation of platelets in the blood, preventing the formation of fibrinogen and platelets clots (white thrombus) on the walls of blood vessels, clots that usually precede the formation of real clots (red thrombus) formed by red blood cells and fibrin constituted in part by a platelet conglomerate and in part by clotted blood;


  • Antianginal agents: the antianginal drugs are used in the treatment of pain associated with angina pectoris crisis due to the state of anoxia infarction. They stimulate the coronary blood flow and cause coronary and peripheral vasodilation;


  • Antiarrhythmics: antiarrhythmic drugs are used in the pharmacological treatment of various forms of arrhythmia. They can be divided into active drugs on ventricular and supraventricular arrhythmias (quinidine), drugs that act primarily on ventricular arrhythmias (lidocaine), and drugs that act on supraventricular arrhythmias (verapamil);


  • Anticoagulants: anticoagulant drugs are substances that interfere with the process of blood clotting, slowing or preventing it;


  • Antihypertensive agents: the antihypertensive drugs are used in the control of hypertension for their ability to interfere with the mechanisms that physiologically regulate the pressure;


According to the different mechanism of action these can be divided into four groups:


  • Drugs that affect the sodium-water balance (diuretics);


  • Drugs that act on the functionality of the sympathetic nervous system (sympatholytic);


  • Drugs that act on the members of the nerve centers to the control of vascular motility (vasoconstriction and vasodilation);


  • Medications that act on the renin-angiotensin system (hormonal mechanism that regulates blood pressure, total circulating blood volume and tone of the arterial muscles);


Diuretics: diuretics are used to stimulate the secretion of water and electrolytes from the kidneys by increasing the production and excretion of urine (diuresis). They are used for treating hypertension, edematous states, in cases of hypervolemia and in cases where it is necessary to quickly remove waste and toxic substances from the body. Depending on the mechanism of action, the diuretic drugs can be divided into six groups:


  • Thiazide diuretics: inhibiting the reabsorption of sodium and chloride in the renal tubules, causing a corresponding increase in potassium excretion (chlorothiazide and compounds of similar structure as chlorthalidone, indapamide, and metolazone the mefruside);


  • Loop diuretics: they produce an intense dose-dependent diuresis of relatively short duration (furosemide, bumetanide, ethacrynic acid);


  • Diuretics that reduce the loss of potassium (amiloride, triamterene, aldosterone inhibitors);


  • Inhibitors of carbonic anhydrase mainly used to reduce intraocular pressure in glaucoma (acetazolamide, diclorofenamide);


  • Osmotic diureticsused to reduce or prevent cerebral edema and to reduce intraocular pressure (mannitol, urea);


  • Mercurial diuretics (Mersalyl), which are now of little importance from a therapeutic point of view;


  • Fibrinolytics: the fibrinolytic drugs are thrombolytic agents used to dissolve, and then remove, a clot from the lumen of a blood vessel;


  • Cardiac stimulants: substances with a stimulating effect on some of the cardiac functional activities. The most important are the peripheral stimulants with a direct action on the myocardium. Other drugs of this type are the peripheral ganglion stimulants, peripheral vascular stimulants, direct central stimulating action on the cardioacceleratory center, and sympathomimetics;


Lipid-lowering agents: the lipid-lowering drugs are used to counter the harmful presence of an excessive concentration of lipids in the blood. Based on their mechanisms of action they can be divided into several groups:


  • Statins: group of effective pharmacological agents in the treatment of hypercholesterolemia, which act by inhibiting the synthesis of cholesterol;


  • Fibrates: drugs used in the treatment of hypertriglyceridemia by acting on specific receptors that play a key role in adipogenesis;


  • Resins sequestering the bile acids: drugs used to reduce cholesterol levels in the blood, which act by inhibiting the reabsorption of a portion of the bile acids that are removed from the enterohepatic circulation;


  • Probucol: cholesterol-lowering drug that can cause a modest decrease in blood levels of LDL and HDL cholesterol. Its use is recommended for those patients with elevated plasma concentrations of LDL that cannot be reduced with dietary treatment alone or with other medications;


  • Ezetimibe: antidyslipidemic medication used in hypercholesterolemia due to its ability to decrease cholesterol absorption in the intestine by binding to a key mediator of this process;


  • The vasoactive agents: the vasoactive drugs are substances capable of acting on the members of the nerve centers to the control of vascular motility (vasoconstriction and vasodilation);


  • Antiatherosclerotic agents: drugs to prevent or treat the formation of atheromatous plaques within the arteries or aterotomatose;


  • Acetyl salicylic acid: used in the prophylaxis. Inhibits the participation of platelets at the atherosclerotic process;


  • Calcium channel blockers: show preventive action in the formation of coronary lesions;


  • Beta-blockers: they reduce platelet aggregation or have an antioxidant action;


  • ACE inhibitors: they have protective effects on the endothelium;


How should cardiovascular drugs be taken?


Cardiovascular drugs are available in the form of tablets or capsules to be taken orally or in the form of solutions for injections. They must always be used under prescription and by strictly following the instructions of a doctor regarding dosage and mode of application. Not doing so can reduce the absorption of the drug or render the treatment useless as well as cause a health risk.


Contraindications and warnings associated with the use of cardiovascular drugs


There are many cardiovascular drugs and of different types, which also act on very different mechanisms between them. They can therefore give rise to several side effects, which may also vary according to the dosage. In general, however, the intake of these drugs can lead to:


  • Gastrointestinal disorders: nausea, vomiting, diarrhea, and abdominal pain;
  • Dermatological disorders: rash, angioedema;
  • Musculoskeletal disorders: muscle and joint aches, muscle cramps;
  • Systemic disorders: fever, lethargy, drowsiness, headache, sleep disturbances, and low blood pressure;
  • Metabolic disorders: Liver and kidney dysfunction;


In cases of pregnancy and nursing, administration of cardiovascular drugs requires careful evaluation of the clinical benefits for the mother and the potential risk to the unborn child. Contraindications exist even in the case of patients with asthma, renal diseases, liver diseases and diabetes.