There are several different classes of medications to prevent and reverse heart disease. However, two of these stand out and should be strongly considered by anyone desiring to prevent a heart attack
The first class are called statins. Their function is to inhibit the liver's ability to make cholesterol. As might be expected, there are both first generation and second generation FDA approved statins. They differ in their potency, side effects, and the way the body removes them. In this class, we prefer either a statin called - atorvastatin - which is a generic medication (when it was a brand name only medication, it was all Lipitor) or a brand name only medication called Crestor (the generic name is rosuvastatin but you can not yet buy is as a generic). If you are to achieve an LDL cholesterol below 50 mg/dl, you will probably need to take one of these medications.
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The second class of medications are called cholesterol blockers. There is only one FDA approved medications in this class and its brand name is Zetia (generic name is ezetimibe). It is not for sale as a generic medication. This drug partially blocks the absorption of cholesterol in the intestine and will lower your LDL cholesterol by about 25%.
The third class of medications are called platelet inhibitors. Aspirin is the most common medication in this class. Because a heart attack includes a blood clot at the site of the plaque in the coronary artery, a baby aspirin (81 mg/day) has been shown to be helpful, particularly in diabetic people. Aspirin is the same, no matter what the brand so buy the most inexpensive enteric coated baby aspirin you can find.
When we begin patients on cholesterol lowering medication, a good starting point is what is often called "ten and ten" - that is, 10 mg of ezetimibe and 10 mg of atorvastatin (or rosuvastatin). Both medications are taken any time, once per day.