Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States.[1] Conditions such as high blood pressure and high cholesterol are key risk factors for heart disease.

And while managing these health conditions with prescription medications is critically important, it's also important to consider how these medications affect your body's ability to absorb and use nutrients. Many common medications for managing heart disease may cause nutrient deficiencies, but don't despair - you have the ability to fight back. 

Common heart disease medications and how to prevent related nutrient deficiency

Medications for decreasing your risk of stroke or heart attack, lowering your blood pressure or cholesterol, and reducing your chance of blood clots are critical to improving your cardiovascular health. While there are risks for nutrient deficiency, you can take action by understanding how the medication impacts your body and creating the right plan.

Statins

• Atorvastatin (Lipitor)
• Fluvastatin (Lescol)
• Pravastatin (Lipostat)
• Rosuvastatin (Crestor)
• Simvastatin (Zocor)

Statins are commonly prescribed to manage cholesterol. The potential primary nutrient deficiency associated with statin use is low Coenzyme Q10 (CoQ10) levels. Since the body cannot make its own, CoenzymeQ10 supplementation is crucial and highly. Some statin drugs could also lead to deficiencies in vitamin D, calcium, and potassium.

Cardiac glycosides

• Digoxin (Lanoxicaps, Lanoxin, Digibind)
• Digitoxin (Crystodigin)

These drugs are prescribed to prevent heart failure and irregular heartbeats. Cardiac glycosides result in deficiencies of calcium, magnesium, thiamine (Vitamin B1), and phosphate. Studies show that cardiac glycosides could deplete magnesium levels in heart muscles leading to magnesium deficiency [2].

Beta-blockers

• Atenolol (Tenormin)
• Bisoprolol (Cardicor, Emcor)
• Carvedilol.
• Metoprolol (Betaloc, Lopresor)
• Nebivolol (Nebilet)
• Propranolol (Inderal)

Beta-blockers are used to lower blood pressure, slow down the heartbeat, and widen the arteries and veins to facilitate blood flow. Long-term use of beta-blockers is found to lower CoenzymeQ10 levels. As noted above, the body cannot make its own CoenzymeQ10, so supplementation is highly recommended.

Thiazide diuretics

• Microzide (Hydrochlorothiazide or HCTZ)
• Thalizone (Chlorthalidone)
• Enduron (methyclothiazide)

These drugs are used to lower high blood pressure, congestive heart failure, and to prevent fluid accumulation typical in kidney problems. Being a diuretic works by increasing urine production, which could lower the levels of micro minerals like magnesium and potassium.

Anticoagulants (Blood thinners)

• Warfarin
• Rivaroxaban (Xarelto) 
• Dabigatran (Pradaxa) 
• Apixaban (Eliquis)
• Edoxaban (Lixiana)

Blood thinners are prescribed to prevent clot formation and lower the risk of angina, heart attack, and heart problems. Blood thinners like aspirin, coumadin, and heparin can cause internal bleeding and cause iron loss. Iron deficiency leads to anemia characterized by dizziness and fatigue.

Ways to reduce side effects through nutritional supplements

Don't let nutrient deficiencies be the price you pay for effective drug therapy. If you are prescribed a medication for long-term use, be sure to ask your healthcare provider about possible side effects concerning nutrient deficiencies. Lack of awareness and prolonged use of prescription drugs are the two major risk factors for drug-induced nutrient deficiencies. You can avoid risk and unnecessary complications that may arise due to nutrient deficits by choosing suitable supplements. Some key points to remember when taking nutritional supplements:

· Never take dietary supplements at the same time you take the prescription medication.

· Make your diet a part of the solution to prevent nutrient deficits.

· Keep track of your nutritional status by monitoring your blood work under your provider's supervision.

· Always read the literature that comes with your medication and educate yourself about the effects of its long-term use.

· Check with your doctor if you can switch your prescription to reduce the risk of deficits.

A nutrient deficiency may not have apparent symptoms yet; it could be robbing you of vital minerals and vitamins. Your medications are, no doubt lifesaving and should never be discontinued without consulting your doctor. The best approach is to talk to your doctor about your concerns about deficiency when taking cardiovascular drugs and get started on a high-quality supplement. Appropriate use of dietary supplemntes could prevent deterioration of health and may bolster faster recovery. Besides taking dietary supplements adopting healthy food and lifestyle choices is crucial to improving your heart and overall well-being. 

We at CAMFormulas and Local Health Pharmacy are here to help you navigate your whole health picture, from prescriptions to supplements, so you can have the peace of mind and enjoyable lifestyle that your best health provides. To schedule a free consultation with our Pharmacy team today, connect with us via chat on the CAMFormulas homepage and click the message button in the lower right corner.

1. Centers for Disease Control and Prevention. Underlying Cause of Death, 1999–2018. CDC WONDER Online Database. Atlanta, GA: Centers for Disease Control and Prevention; 2018. Accessed March 12, 2020.
2. Hypomagnesemia and cardiovascular system //www.ncbi.nlm.nih.gov/pmc/articles/PMC2464251/