What is a common medication given to decrease cardiac workload?

• A. Lisinopril
• B. Metoprolol
• C. Nitroglycerin
• D. Aspirin

Answer: (A)

Reducing cardiac workload means easing the heart’s pumping effort by lowering the pressure against which it must eject blood (afterload) and, over time, the volume it has to move (preload). Lisinopril is an ACE inhibitor that lowers afterload by causing arterial dilation, which reduces systemic vascular resistance. With less resistance to overcome, the heart can eject blood with less wall stress, cutting myocardial oxygen demand and energy use. It can also modestly reduce preload over time by decreasing aldosterone-driven fluid retention, further easing the heart’s workload. While other drugs like beta-blockers can also reduce workload by lowering heart rate and contractility, lisinopril’s primary effect in this context is through decreased afterload. Nitroglycerin mainly lowers preload acutely, and aspirin does not directly reduce workload.