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After a stroke and during your rehabilitation you will need medicines to help prevent another stroke. You may need medicine to thin your blood and prevent clots from forming and medicines to lower blood pressure and cholesterol.
Medicines you may take after a stroke include:
Antiplatelets to prevent blood clots.
Aspirin is an antiplatelet medicine that decreases blood clot formation by preventing the smallest blood cells, or platelets, from sticking together and forming blood clots. Aspirin is the most commonly used medicine to prevent stroke. It reduces the risk of stroke in people who have already had a transient ischemic attack (TIA) or ischemic stroke, also known as a "mini-stroke." This type of stroke is caused by a temporary clot in the brain.
Aspirin or other antiplatelet drugs may reduce the risk of stroke in people who cannot have surgery to reopen a blocked carotid artery. Aspirin with extended-release dipyridamole is used to reduce the risk of additional strokes or TIAs in people who had a stroke or TIA while taking aspirin.
Anticoagulants to keep clots from growing and to prevent new clots.
Although anticoagulants are often called blood thinners, they do not really thin blood. Warfarin prevents the production of certain proteins that are necessary for blood to clot. Heparin and newer low-molecular-weight heparins interfere with the complex process of blood clot formation. Heparin and warfarin prevent new clots from forming and may prevent existing clots from getting larger. They do not break up clots.
Treatment with heparin followed by warfarin is often recommended for people whose TIA or stroke was likely caused by a clot formed in the heart. Heparin often is used first because it can be given quickly into a vein and it has an immediate effect on clotting. Warfarin is used long-term after heparin use is ended.
Statins to lower cholesterol.
Statins block an enzyme the body needs to produce cholesterol. As a result, LDL ("bad") cholesterol levels in the blood go down, thereby lowering total blood cholesterol levels.
Statins may be taken alone or taken with other cholesterol medicines such as fibric acid derivatives, bile acid sequestrants, or nicotinic acid. Statins may also be combined with other types of medicines into one drug. For example, Vytorin is a combination medicine that lowers cholesterol in two ways: with a statin, which blocks the production of cholesterol in the body; and with ezetimibe, which reduces the amount of cholesterol absorbed by the intestines. Examples of statins include Lipitor, Crestor and Zocor.
Angiotensin-converting enzyme (ACE) inhibitors to lower blood pressure.
Angiotensin-converting enzyme (ACE) inhibitors block an enzyme needed to form a substance that narrows blood vessels. As a result, blood vessels relax and widen, making it easier for blood to flow through the vessels, which reduces blood pressure. These medicines also increase the release of water and sodium to the urine, which also lowers blood pressure. ACE inhibitors can be used alone or in combination with a diuretic or other agents.These medicines are used alone for high blood pressure or they are used with other medicines such as a diuretic or beta-blocker.
Angiotensin II receptor blockers (ARBs) to lower blood pressure.
These medicines block the action of a hormone that causes blood vessels to narrow. As a result, blood vessels may relax and open up. This makes it easier for blood to flow through the vessels, which reduces blood pressure. Also, these drugs increase the release of sodium and water into the urine, which also lowers blood pressure.
Angiotensin II receptor blockers (ARBs) may be used alone or combined with other medicine-often a diuretic-to treat high blood pressure. ARBs may be used by people who cannot take ACE inhibitor medicines. ACE inhibitors can cause an annoying cough. This cough may be hard for some people to live with. So doctors may prescribe an ARB instead. ARBs are less likely to cause a cough.
Beta-blockers to lower blood pressure.
Beta-blockers lower the heart rate, the amount of blood the heart pumps out, and the force of the heart beat, all of which lower blood pressure.
For high blood pressure, most beta-blockers are taken once or twice a day. They may be combined with a diuretic in the same pill.
Beta-blockers are widely used for high blood pressure, either alone or combined with other medicines including diuretics, ACE inhibitors, or calcium channel blockers. These medicines may be especially useful in people who also have angina or who have had a heart attack, small aortic aneurysms, migraine headaches, or an anxiety disorder.
Diuretics to lower blood pressure.
Diuretics cause the kidneys to remove more sodium and water from the body which helps to relax the blood vessel walls, thereby lowering blood pressure. Diuretics often are combined with other high blood pressure medicines. Using both a diuretic and another medicine often works well because diuretics can enhance the effect of the other medicines and sometimes prevent the fluid retention that can occur.
Diuretics are recommended as the first line of treatment for high blood pressure. They are usually recommended as one of at least two medicines to control high blood pressure.
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