Heart Shield
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MEDICATIONS OFTEN PRESCRIBED FOR PATIENTS WITH HEART DISEASE: BETA BLOCKERS
Beta blockers are a family of drugs that counteract the effects of adrenaline and other similar hormones on the body. They are extremely effective in reducing the workload of the heart, treating chest pain or discomfort, lowering high blood pressure and preventing the recurrence of heart attacks or death after an initial attack. These are undoubtedly the best “all-purpose drugs” for patients with coronary heart disease. Why are they so useful?
Simply put, the “sympathetic nervous system” of the human body uses adrenaline as one of its main “defense tools” in the “fight or flight response” to severe physical stresses. While this response was essential for our primitive forebears and their perilous hunter-gatherer culture, in modern Western society, we face very different kinds of stresses, for which we may be biologically poorly adapted. Modern life is marked by continuous low-grade stress, such as that produced by crowding in urban environments, dealing with complex social structures, multiple conflicting demands on our time and attention, and ambiguous social situations where there is no single right course of action. The adrenergic nervous system, which was adapted to deal with sudden bursts or pulses of adrenaline at infrequent intervals, is very poorly adapted to defending against the stresses of modern society. Chronic low-grade activation of the adrenergic nervous system is, in fact, harmful. It is for this reason that beta blockers, which directly counteract the effects of adrenaline on the heart, may be so useful. Beta blockers slow the heartbeat, slightly weaken the force of contraction of the heart, and lower blood pressure. Although it might seem that a drug that can even slightly weaken the pumping action of an already damaged heart would be harmful, in fact beta blockers seem to protect a weakened heart from further damage and weakening. Most patients with coronary heart disease should be on one of many different kinds of beta blockers available. Their main side effect is fatigue, and occasionally excessive slowing of the heartbeat.
A word about heart rate is important here. Although beta blockers can slow the heartbeat quite a bit in some cases, to as low as fifty beats per minute or below, this is not dangerous, and, in fact, if patients do not suffer from undue fatigue or lightheadedness, it is probably beneficial. It is useful to imagine that one has a certain number of heartbeats available over a lifetime, which can be used up ‘quickly” or slowly, depending on how fast the heart is beating.
In general, the slower the heartbeat, the better off you are?and this is certainly true after a heart attack, when patients with a fast heartbeat have a poorer outlook than those with a slow heartbeat. Although the heartbeat is increased during exercise, patients who exercise regularly, including those with heart disease, will have in general a slower heartbeat at rest, which of course accounts for most of the hours of the day.
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