Written and medically reviewed by Dorcas Morak, Pharm.D
Every World Heart Day, observed globally on September 29, reminds us that cardiovascular disease remains the world's leading cause of death. The good news is that roughly 80% of premature heart disease is considered preventable through healthy lifestyle habits and appropriate medical care. Alongside a heart-healthy diet, regular exercise, not smoking, and managing conditions like diabetes and high blood pressure, several medications have been proven to reduce the risk of heart attacks, strokes, and other cardiovascular complications. Here's what you should know about the medications your doctor may recommend and why they matter.
Who Needs Medication to Prevent Heart Disease?
Doctors consider several factors when deciding whether medication is appropriate for heart disease prevention, including blood pressure, cholesterol levels, diabetes, smoking status, family history, age, kidney function, and overall cardiovascular risk. People with a higher calculated risk—or those who have already experienced a heart attack, stroke, or other cardiovascular event—are often prescribed medications to help reduce the chance of future complications. Not everyone needs the same medications. Your healthcare provider will recommend treatment based on your individual health history and risk factors.
Best Statins for Heart Disease Prevention
Statins remain the cornerstone of cholesterol management for preventing heart disease. Medications such as atorvastatin (Lipitor) and rosuvastatin (Crestor) lower LDL ("bad") cholesterol by blocking cholesterol production in the liver while also helping stabilize plaque buildup inside artery walls. Together, these effects significantly reduce the risk of heart attacks and strokes. Current cardiology guidelines recommend statins based on an individual's overall cardiovascular risk rather than cholesterol numbers alone.
Blood Pressure Medications That Reduce Heart Disease Risk
High blood pressure is one of the biggest contributors to heart disease and stroke. Keeping blood pressure under control reduces strain on the heart and blood vessels. Several types of medications may be prescribed, including:
- ACE inhibitors such as lisinopril
- Angiotensin receptor blockers (ARBs) such as losartan
- Calcium channel blockers such as amlodipine
- Thiazide diuretics such as hydrochlorothiazide
Your healthcare provider will choose the medication or combination of medications that best fits your health needs.
When Are Beta-Blockers Recommended?
Beta-blockers such as metoprolol (Toprol XL, Lopressor) and carvedilol (Coreg) slow the heart rate and reduce the heart's workload. While they are no longer routinely prescribed as first-line treatment for uncomplicated high blood pressure, they remain an important therapy for people who have:
- Had a heart attack
- Heart failure with reduced ejection fraction
- Certain abnormal heart rhythms (arrhythmias)
These medications can improve survival and reduce future cardiovascular events in the right patients.
Should You Take Aspirin to Prevent Heart Attacks?
Low-dose aspirin is no longer routinely recommended for adults without existing cardiovascular disease because the risk of serious bleeding often outweighs the benefits.
However, aspirin is still commonly recommended for secondary prevention—people who have already experienced a heart attack, ischemic stroke, or have had a coronary stent placed. Never start or stop taking daily aspirin without first discussing it with your healthcare provider.
Additional Cholesterol Medications Beyond Statins
Some people need additional cholesterol lowering beyond what statins can provide or cannot tolerate statins. In these situations, doctors may prescribe medications such as:
- Ezetimibe (Zetia)
- PCSK9 inhibitors such as evolocumab (Repatha) or alirocumab (Praluent)
- Bempedoic acid (Nexletol)
PCSK9 inhibitors can lower LDL cholesterol by an additional 50% or more when combined with statin therapy.
Diabetes Medications That Also Protect Your Heart
Some diabetes medications provide cardiovascular benefits beyond lowering blood sugar. Examples include:
- SGLT2 inhibitors such as empagliflozin (Jardiance) and dapagliflozin (Farxiga)
- GLP-1 receptor agonists such as semaglutide (Ozempic) and liraglutide (Victoza)
For eligible patients with type 2 diabetes and cardiovascular disease—or those at high cardiovascular risk—these medications can help lower the risk of heart attack, stroke, hospitalization for heart failure, and other cardiovascular complications.
Blood Thinners for AFib Stroke Prevention
People with atrial fibrillation (AFib) have an increased risk of blood clots that can travel to the brain and cause a stroke. Anticoagulants, often called blood thinners, help reduce this risk. Common examples include:
Your healthcare provider will determine whether an anticoagulant is appropriate based on your individual stroke and bleeding risk.
Why Taking Heart Medications Consistently Matters
Heart disease prevention medications are most effective when taken exactly as prescribed. Skipping doses, stopping medications because you feel better, or discontinuing treatment due to side effects without talking to your healthcare provider can increase the risk of heart attack, stroke, or worsening heart disease.
If you're experiencing side effects or having difficulty affording your medications, speak with your doctor or pharmacist. There may be alternative medications or lower-cost options that better fit your needs.
Can Lifestyle Changes Reduce the Need for Medication?
Healthy habits remain the foundation of heart disease prevention. Eating a balanced diet, exercising regularly, maintaining a healthy weight, controlling diabetes, limiting alcohol, and quitting smoking all help reduce cardiovascular risk.
For people who smoke, smoking cessation medications such as varenicline (Chantix) or nicotine replacement therapy may improve the chances of successfully quitting, providing additional heart health benefits.
For many people at higher risk, however, lifestyle changes work best alongside medication rather than replacing it entirely.
How to Save Money on Heart Disease Medications
Managing heart disease often means taking one or more medications long-term, and those costs can add up over time. Whether you take atorvastatin, lisinopril, metoprolol, Eliquis, Jardiance, or several heart medications together, comparing pharmacy prices may help reduce your out-of-pocket costs.
The RxLess® Assurance Plan makes it easy to compare prescription prices at more than 70,000 pharmacies nationwide before you fill your medication. By checking prices in advance, you may be able to lower your out-of-pocket costs and avoid paying more than necessary. Simply download the free RxLess® app from the Apple App Store or Google Play to automatically become a member of the RxLess® Assurance Plan.
