Heart disease treatment

How heart disease medications work

You will note that the medications listed below are categorized by condition. If you have high cholesterol, for example, you’ll look under that topic for the medications that are regularly prescribed for that condition. Simply click on that drug and it will link you to the information. While we have listed many of the current generic medications that are prescribed for heart disease in Canada, you may find that your medication may not be covered in this section. Please speak to your physician. This information is to help you better understand how medications work and is not meant to replace your health-care practitioner's advice. We also include information onhow to take and manage your medications below.

Angina

Beta-Blockers

Calcium Channel Blockers (CCBs)

Nitrates (Nitroglycerin)

Cholesterol

Cholesterol Absorption Inhibitors (ezetimibe)

Fibrates

Niacin

Resins

Statins

Heart failure

Angiotensin converting enzyme (ACE) inhibitors

Angiotensin receptor blockers (ARB)

Beta-blockers

Aldosterone antagonists (Mineralocorticoid receptor antagonists) (Eplerenone or Spironolactone)

Digoxin

Diuretics

Neprilysin inhibitor/Angiotensin II receptor blocker

Heart disease

Anticoagulants

Anti-platelets (acetylsalicylic acid (ASA), clopidogrel, dipyridamole, ticlopidine)

Warfarin

High blood pressure

ACE Inhibitors

Angiotensin Receptor Blockers (ARBs)

Beta-blockers

Calcium Channel Blockers

Diuretics

Irregular heart rhythms

Antiarrhythmics

How to take your medication

Some heart medications treat heart disease and some help prevent it. They all work in different ways. Some may help lower your blood pressure, reduce the level of cholesterol in your blood or help your body get rid of excess fluids that make it difficult for your heart to pump blood. Always talk to your doctor or pharmacist to find out exactly how and when to take your medication. Here are some general tips to help you take your medication properly:

Take as prescribed

Always take your medications as prescribed. Never suddenly stop taking or change them without first talking to your doctor or pharmacist.

Know what you’re taking

Be sure you know the names and dosages of the medications you are taking and a little bit about how they work. Make a list of your medications to keep with you in your purse or wallet. Before having surgery, including dental surgery, tell your doctor or dentist what medications you are taking. An antibiotic may need to be prescribed prior to your surgical or dental procedure.

Stick to a routine

If you take your medications at the same times each day such as at lunch and dinner, it’s easier to remember when and if you took your pills. It may also help to use a pillbox (like a Dosett) marked with days of the week or have your pharmacist package your medications in blister packs.

Avoid mixing prescription medications with over-the counter drugs

If you are taking medications, do not take any over-the-counter drugs or herbal therapies without first checking with your doctor or pharmacist. Some drugs, such as antacids for stomach upset, salt substitutes, antihistamines for allergies and nonsteroidal anti-inflammatory medications for pain relief or headaches (such as ibuprofen), can worsen certain heart conditions. Avoid potentially dangerous drug interactions by telling your doctor or pharmacist about any other medication including prescription, non-prescription or natural health products such as vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional Chinese medicines, probiotics and other products such as amino acids and essential fatty acids.

Talk to your pharmacist

If you have any questions about your medications, forget to take a dose, experience potential drug interactions, or need refills talk to your pharmacist. Also remember that your doctor is only a phone call away.

Report side effects

If a medication is causing unpleasant side effects, report them to your doctor or pharmacist. Sometimes your doctor can help you eliminate side effects simply by changing the dose, suggesting that you take the medication at a different time or using a different drug.

Lifestyle changes

Eating a healthy diet that is lower in salt and fat, especially saturated and trans fats, being smoke free, limiting alcohol use, being physically active and reducing stress are also important to lowering the risk of stroke and heart disease. Talk to your health-care practitioner about how you can achieve these lifestyle changes.

How to pay for your medication

When you are in the hospital, your provincial health plan pays for all of your medications. When you return home, however, you will have to pay for them either individually or through a provincial or private drug plan. If you need financial help to pay for your medications, you may discuss your situation with your workplace human resources department, a union representative, a social worker, a provincial or private health insurance program representative or a pharmacist. Visit your ministry of health to learn more about the drug benefit programs in your province or territory. Visit Canadian Life and Health Insurance Association to learn more about private supplementary health insurance, which may cover some of your prescription drugs or medical expenses.

For more information

Health Canada provides health and medical information to help Canadians maintain and improve their health. Learn more about Safe Use of Medicines, Safety and Effectiveness of Generic Drugs and Buying Drugs over the Internet.

Drug Product Database provides information about drugs approved for use in Canada.

MedEffect Canada provides safety alerts, public health advisories, warnings and recalls.

Your ministry of health also provides useful health resources in your province or territory. For example, Ontario has a MedsCheck program providing free pharmacist consultations on safety use of drugs. British Columbia has a Senior Healthcare webpage providing information about important health programs.  

Surgeries and other procedures

Below is a list of surgeries and other procedures that are currently performed in Canada.  

Ablation

Atherectomy

Cardiac Resynchronization Therapy (CRT) (Biventricular Pacemaker) 

Cardioversion therapy

Coronary artery bypass surgery

Heart transplant surgery

Heart valve surgery: repair and replacement

Implantable cardioverter defibrillator (ICD)

Implantable pacemaker

Mechanical assist device

Percutaneous coronary intervention (PCI or angioplasty with stent)

Ventricular resection

Financial & Health Insurance Information for Patients with Congenital Heart Disease

If you or your child was born with a heart defect (congenital heart disease), paying for treatment will usually involve using different types of resources - whether those resources are private insurance, government programs, or out-of-pocket payments. Complicated medical tests or procedures can be expensive, so it is particularly important that patients who will need treatment and follow-up throughout their lives maintain some form of active medical coverage. It is crucial to avoid gaps in medical coverage during the transition from childhood to adult care. Once insurance coverage is lost, it can lead to long delays in coverage and can be very difficult to get back. Talk to your healthcare providers specifically about how to prevent gaps in coverage.

Additionally, patients with congenital heart disease may experience periods of disability (depending on the severity of the defect) and require assistance in meeting living expenses. For those who qualify, government assistance may be available.

Please read on for information about resources that may be available to you to help you meet medical and living expenses. Applying for coverage or assistance can involve lengthy paperwork and documentation of medical conditions. Hospital social workers, financial and health insurance counselors, and appropriate local, state, and federal staff can help you with application processes. One of the advantages of medical centers that specialize in pediatric and adult congenital heart disease is that care team members will typically have the best and most up-to-date information about the changing landscape of health insurance coverage.

• Covering Treatment Costs
• Covering Living Expenses
• Compassionate Allowances

Covering Treatment Costs

If possible, strive to maintain some form of medical coverage at all times. Breaks in coverage can lead to difficulties in obtaining coverage, waiting periods for coverage of pre-existing conditions, and large out-of-pocket expenses. Make sure any renewals in coverage are dealt with promptly and completely before any expiration dates. Please note that under the Affordable Care Act,health insurance carriers will be prohibited from rejecting applicants on the basis of pre-existing conditions.

• Private insurance. This form of coverage is what you may think of as traditional health insurance. It is available through an employer-sponsored plan or can be purchased individually. If you are offered options for different plans through an employer, or are applying for private insurance with carriers that have physician networks in your area, be mindful of choosing (when possible) a plan that is accepted by your current physicians and hospital. Visits to “out of network” providers may incur heavy additional expenses. Also, you will want to seek a plan that has the right balance of premiums, deductibles, copayments, and out-of-pocket maximums for you and your family. If you need help determining what this balance might be, your employer’s human resources department, your prospective insurance carrier, a hospital social worker, or a financial planner may be a source of more information or assistance.

• Medicaid and the Children’s Health Insurance Program (CHIP). Medicaid provides free or low-cost health insurance coverage to individuals and families based on income and other factors. CHIP provides low-cost health insurance coverage to children up to age 19, based on family income. The eligibility rules for each program are established by the individual states. More information about each program is available at the federal Centers for Medicare and Medicaid Services website. This website can help direct you to resources for your state. Your hospital social worker can also assist you in finding out more about Medicaid and CHIP. Even though they sound similar, Medicaid is administered by each state rather than the federal government, unlike Medicare, so the rules can differ depending on where you live.

• Medicare. This federal program provides health insurance and prescription drug coverage for seniors age 65 and over, some individuals with disabilities, and anyone with end-stage renal disease (permanent kidney failure). More information about Medicare is available at www.medicare.gov, the official Medicare website for the federal Centers for Medicare and Medicaid services.

Information and counseling for seniors who wish to apply for (or are already using) Medicare and/or other forms of health insurance coverage can be obtained from your State Health Insurance Counseling and Assistance Program (SHIP).An Internet search using terms such as your state’s name and “SHIP insurance” should direct you to your state’s SHIP website. Additionally, your hospital social worker can help you to apply for Medicare or to coordinate your existing benefits.

• Pre-Existing Condition Insurance Plan (PCIP). PCIP is coverage for patients who:

• do not currently have any form of health insurance (including private insurance, state high risk pool insurance, and programs such as Medicare and Medicaid); and
• have been without insurance for at least six months; and
• have been rejected by another insurance plan due to a pre-existing condition.

Depending on the state in which you live, a plan may be run by either the state or the U.S. Department of Health and Human Services. Information about PCIP is available at https://www.pcip.gov. Links to information for each state are also available at that website. PCIP is a bridge program of the Affordable Care Act that is intended to help patients with pre-existing conditions obtain health insurance coverage until 2014, when insurance carriers will be prohibited from rejecting applicants based on these conditions.

• Multiple insurances. If you have health insurance coverage from a variety of sources - such as private insurance, Medicare, and Medicaid—your medical expenses will be covered in an order determined by the types of coverage. For example, if you have private insurance and Medicare, many expenses may be covered by private insurance first, with Medicare paying remaining expenses. Be sure to make your healthcare providers aware of all forms of health insurance coverage you have. Your medical office or hospital’s billing department will submit bills to your insurance carriers in the appropriate order.

Covering Living Expenses

• Supplemental Security Income (SSI). This federal program, which is different from Social Security retirement benefits, is designed to help people who are age 65 or older, blind, or disabled and who have limited income or resources to meet basic living expenses such as those for housing, clothing, and food. Children who meet disability requirements are eligible for SSI until the age of 18, at which point they can be reevaluated for SSI eligibility as an adult. Information about SSI is available through the U.S. Social Security Administration (SSA) website at http://www.ssa.gov/pgm/ssi.htm. SSI payments vary by state. Your local Social Security office or a hospital social worker can provide more information. An online search tool to locate your local Social Security office is available at https://secure.ssa.gov/apps6z/FOLO/fo001.jsp.

• Social Security Disability Insurance (SSDI). This Social Security program delivers disability payments to adults who become disabled after having been in the workforce for a certain amount of time. In some cases, family members such as an adult child with a disability (if the disability occurred before age 22) may also be eligible to receive benefits. Information about SSDI is available through the U.S. Social Security Administration (SSA) website athttp://www.ssa.gov/pgm/disability.htm.

Compassionate Allowances

Certain diseases and medical conditions are recognized by the U.S. Social Security Administration (SSA) as serious enough to require expedited provision of Social Security benefits. Several congenital heart defects and other cardiovascular conditions are currently on the list of recognized Compassionate Allowances conditions. Information about Compassionate Allowances is available from the SSA website at http://www.socialsecurity.gov/compassionateallowances/. A list of qualifying medical conditions can be accessed at http://www.socialsecurity.gov/compassionateallowances/conditions.htm.

Questions to Ask Your Doctor About Financial and Health Insurance Information

The following questions can help you talk to your physician or healthcare team. Print out or write down these questions and take them with you to your appointment. Taking notes can help you remember what you heard when you get home.

• What information do you need from me (medical records, etc.), and how can I get that information?
• How do I obtain/keep health insurance?
• What other professionals may be of benefit to me (health insurance/financial counselors, social workers, mental health counselors, career counselors)?
• What federal or state programs may be available to help me with medical costs?
• What federal or state programs may be available to help me with living expenses?

Health Insurance for Cardiac Patients

Buying a critical illness insurance and health insurance plan providing cover for pre-existing illness was never easy. Companies have dedicated plans in order to cater to this need. Our life is uncertain and we are not aware of the fact that any critical illness like heart failure, kidney failure, and stroke can harm us any time and due to rising health care costs and advancement in technology has made these special plans even more important. With changing lifestyles and eating habits, these diseases occurrence has seen a visible trend. So, it makes sense to buy health insurance plans covering critical illnesses before they attack us.

Insurance for senior citizens is one such other special plan that has seen various offerings from multiple insurance companies. Insurance Regulatory Development Authority has made it mandatory for insurers to provide insurance for a senior citizen which has benefitted common man to a large extent. As we grow old, we become more prone to diseases and health insurance plan can reduce financial impact of these diseases. In fact, many health insurance providers offer a policy providing insurance for senior citizens along with critical illness insurance which can reap benefit as individual has to buy single policy for multiple coverage’s.

Every health insurance company provides these specialized plans and sometimes it becomes difficult to buy an appropriate plan. An individual has to do various analyses and consider factors like coverage and cost into account before buying a health insurance plan. Critical illness policy and pre-existing plans are special plans which can be compared with the help of insurance aggregators as they provide online tools to compare plans offered by differenthealth insurance companies on a single platform. Comparison of various plans can help you to buy best suitable plan as you can compare all aspects.

Managing diabetes - researchers from the Kaiser Permanente Center for Health Research in Portlant, Oregon, found that diabetes patients need continuous health insurance coverage for the long-term proper management of their disease .

Since the late 1990s, millions of US citizens have found themselves with absolutely no health cover at all. A collection of several different studies and surveys puts the number of "uninsured" Americans at over 50 million; tens of millions more have inadequate insurance.

A Commonwealth Fund 2011 report informed that 26% of all US citizens of working age experienced a gap in health insurance coverage; many lost their health insurance when they either became unemployed or changed jobs.

Children in the USA with private insurance are considerably more likely to have a primary care physician in America compared to those with public insurance or no insurance at all, according to a study carried out by researchers at the Children's Hospital, Boston. The authors added that levels of treatment in emergency departments varied significantly, depending on what type of health insurance they had.

Americans with long-term or serious illnesses are the least able to pay for their medical bills among the leading developed nations in the world, a Commonwealth Fund International Survey reported in November, 2011.

The Affordable Care Act made it possible for young adults aged between 19 and 25 to join or stay on their parents' health plans in 2011. A Commonwealth Fund report informed that 13.7 million young adults remained or got onto their parents' health plans; this included 6.6 million people who would not have been able to do so if the Act had not been signed.

According to an eHealthInsurance survey carried out in 2010, the average monthly premiums among its customers were $167 per month for an individual, with an average deductible of $2,632. Family plans cost an average $392 per month with a $3,531 deductible.

Two broad types of health insurance or health coverage

What Is Health Insurance?

Health insurance is a type of insurance coverage that covers the cost of an insured individual's medical and surgical expenses. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider.

In health insurance terminology, the "provider" is a clinic, hospital, doctor, laboratory, health care practitioner, or pharmacy. The "insured" is the owner of the health insurance policy; the person with the health insurance coverage.

In countries without universal health care coverage, such as the USA, health insurance is commonly included in employer benefit packages and seen as an employment perk.

Is health insurance coverage a human right or another product one can buy?

In some countries, such as the United Kingdom or Canada, health care coverage is provided by the state and is seen as every citizen's right - it is classed along with public education, the police, firefighters, street lighting, and public road networks, as a part of a public service for the nation.

In other countries, such as the USA, health insurance coverage is seen somewhat differently - with the exception of some groups, such as elderly and/or disabled people, veterans and some others, it is the individual's responsibility to be insured. More recently, the Obama Administration has introduced laws making it mandatory for everybody to have health insurance, and there are penalties for those who fail to have a policy of some kind.

Everybody at some time in their life, and often on many occasions, will need some kind of medical attention and treatment. When medical care is required, ideally the patient should be able to concentrate on getting better, rather than wondering whether he/she has got the resources to pay for all the bills. This view is becoming more commonly held in nearly all the developed nations.

Broadly speaking there are two types of health insurance:

• Private health insurance - the CDC (Centers for Disease Control and Prevention) says that the US health care system is heavily reliant on private health insurance. 58% of Americans have some kind of private health insurance coverage.
• Public (government) health insurance - for this type to be called insurance, premiums need to be collected, even though the coverage is provided by the state. Therefore, the National Health Service (NHS) in the United Kingdom is not a type of health insurance - even though it provides free medical services for its citizens, it does not collect premiums - it is a type of universal health coverage.
  
  Examples of public health insurance in the USA is Medicare, which is a national federal social insurance program for people aged 65+ years as well as disabled people, and Medicaid which is funded jointly by the federal government and individual states (and run by individual states), SCHIP which is aimed at children and families who cannot afford private insurance, but to not qualify for Medicaid. Other public health insurance programs in the USA include TRICARE, the Veterans Health Administration, and the Indian Health Service.

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