Nearly half the coronary artery disease (CAD) patients in a seven-year study admitted they don’t consistently take beta blockers, cholesterol-lowering drugs and other medications that could extend their lives, researchers report in Circulation: Journal of the American Heart Association.
Recent focus has been on ensuring that hospitalized patients are prescribed the proper preventive medications at discharge.“However, attention should also be focused on improving long-term and consistent use of those medications,” said Kristin Newby, M.D., lead author of the study and associate professor of medicine at Duke University Medical Center in Durham, N.C.Researchers examined changes in the prevalence and consistency of use of evidence-based secondary prevention medications. From 1995–2002, they found the use of therapies with proven survival benefit in CAD patients has improved.“However, their use remains less than what is optimally needed,” Newby said. “Consistent adherence to these medications was lower despite the fact that failure to use them was associated with lower survival rates.”Researchers tapped the Duke Databank for Cardiovascular Disease to analyze medication adherence among 31,750 patients who had undergone a cardiac procedure at Duke, had at least one coronary artery more than 50 percent blocked or had heart bypass surgery. All patients reported their use of aspirin, beta blockers and lipid-lowering drugs in annual surveys.Patients had to have at least two consecutive surveys returned during the study. Consistent use was defined as reporting use of medications on at least two consecutive occasions and continuing to report use through the end of the study period. Angiotensin-converting enzyme (ACE) inhibitors were reported for patients with and without heart failure. Researchers found the use of all drugs and combinations increased each year. By 2002:
- 83 percent of patients reported using aspirin; 61 percent reported using a beta blocker; 63 percent reported taking a lipid-lowering drug; 54 percent used aspirin plus beta blocker; and
- 39 percent reported using all three drugs.
However, consistent use during the study period was lower. Researchers found: