Question

Chronic Stable Angina and Low-Risk Unstable Angina Mr. Smith is a long term hypertension (HTN), angina, and heart failure (HF) patient. He is aware that his obesity and low exercise habits are contributing to his problems. He has been taking aspirin (ASA) to help with cardiovascular (CV) health, but is starting to have gastric irritation. He asks if there are alternatives. He mentions that he is very happy that he is Class III HF and a level two hypertensive, and his cardiologist has mentioned that he is "only" a class I angina risk.

1. Provide an overview of the interrelated pathophysiology of HTN, angina, and HF.
2. Explain the rationale for use of ASA for all of these indications.
3. What are the alternatives to ASA?

Answer 1

The interrelated pathophysiology of HTN, angina, and HF is characterized by reduced blood flow to the heart muscle due to atherosclerosis. ASA is used for its antiplatelet effects to reduce the risk of heart attack and stroke. Alternatives to ASA include clopidogrel, ticagrelor, and prasugrel.

Step-by-step explanation:

Chronic stable angina is triggered by exertion and improves with rest or nitroglycerin, while low-risk unstable angina occurs at rest and lasts longer. Both conditions are related to reduced blood flow to the heart muscle due to atherosclerosis. Hypertension is persistently elevated blood pressure, which contributes to the development of angina and heart failure.

Aspirin (ASA) is commonly used for its antiplatelet effects to reduce clot formation and thus the risk of heart attack and stroke. It is also used in angina to improve blood flow to the heart. However, gastric irritation is a side effect of ASA.

There are alternative medications to ASA for cardiovascular health such as clopidogrel, ticagrelor, and prasugrel, which also have antiplatelet effects. These medications can be used as alternatives to ASA in patients with gastric irritation. However, the choice of alternative medication should be made in consultation with a healthcare professional.