There are two beta blockers approved for heart failure in the United States.
The first is metoprolol succinate (also called Toprol XL, Toprol, metoprolol ER or metoprolol ER succinate). This long-acting formulation should not be confused with short-acting metoprolol (metoprolol, metoprolol tartrate or Lopressor) which is NOT an approved drug for heart failure.
The second beta blocker approved for the treatment of heart failure is carvedilol (also called Coreg or Coreg CR).
Drugs that are NOT approved for heart failure include atenolol and Bystolic. These are approved to treat hypertension.
NOT APPROVED: metoprolol tartrate, Lopressor, atenolol, Bystolic
APPROVED: metoprolol succinate, Toprol XL, Toprol, metoprolol ER, metoprolol ER succinate, carvedilol, Coreg, Coreg CR
Aspirin acts on the platelets which are the blood clotting cells of the body. It makes them less “sticky” – less likely to form a blood clot.
If a cholesterol plaque inside a blood vessel ruptures, the body’s natural reaction is to form a clot in that area. This can lead to heart attacks (a total blockage of blood flow down a coronary artery) or stroke.
The U.S. Preventive Services Task Force (USPSTF) recommends men with no history of heart disease or stroke who are 45 to 79 years old use aspirin to prevent a heart attack.
It is further recommended that women with no history of heart disease or stroke who are 55 to 79 years old use aspirin to prevent an ischemic stroke.
As with all medications, aspirin should only be used when the benefits outweighs the risk. With aspirin the risks include serious bleeding including GI blood loss from an ulcer or from other parts of the GI tract. The other type of serious bleeding would be a bleeding type of stroke.. Please note the difference between a bleeding stroke and an ischemic stroke where the blood supply is cut off.
As with any medication YOU SHOULD DISCUSS THE RISKS AND BENEFITS OF TAKING ASPIRIN WITH YOUR DOCTOR BEFORE ADDING IT TO YOUR DAILY REGIMEN.
For almost everyone, the recommended dose is 81 mg a day. Almost all aspirin sold is safety coated or enteric coated to protect the stomach and this is probably the best type to take. If someone is hesitant to take it but should be on it, I encourage them to try it every other day or every third day until they feel comfortable taking it daily.
Aspirin has some effect on the platelets for up to 10 days so a little goes a long way.
Please note that this information is people who have never had a cardiovascular event.