Surprisingly, many heart attack victims stop taking their lifesaving medication within three years of the attack. This was the finding of a Mayo Clinic study presented November 5 at the American Heart Association’s Scientific Sessions 2007.
By following patients at 6, 12 and 36 months after an attack, it was found that smokers were more likely to discontinue taking their prescribed medications within three years. Longer term, patients who were enrolled in cardiac rehabilitation programs tended to continue their medications longer than those who were not enrolled.
The researchers recommended a two-program plan for improving the public’s heart health: first, direct education at heart attack patient who are smokers, encouraging them to adopt physicians’ aftercare advice about continuing medications education; and second, encourage all heart patients to participate in a cardiac rehabilitation program, possibly increasing their likelihood of continuing prescribed treatments.
"The study clearly documented that treatments exist that improve outcomes following heart attacks, but patients need to comply with the treatment regimens for the goal of improved patient health to be realized," says Nilay Shah, Ph.D., the study’s lead researcher.
Patients discontinue taking medications too soon for a variety of reasons, including cost, says Veronique Roger, M.D., M.P.H., co-author of the study. More research is crucial to understand and resolve the barriers patients face as they recover from heart attacks she says.
The Mayo researchers evaluated 292 patients enrolled at the Olmsted County, Minnesota registry of heart attack patients, together with their medication histories up to 10 years. These patients had been discharged from the hospital and were taking ACE inhibitors, beta-blockers and statins to help prevent another heart attack.
Results showed that:
- At six months, smokers were significantly less likely to continue all three heart medications compared to nonsmokers.
- At six months, 92 percent of the patients taking statins continued treatment, and by three years only 44 percent of the patients continued taking statins.
- Similarly, the rate of beta-blocker continuation dropped from 89 percent at six months to 47 percent at three years.
- The rate of ACE inhibitor continuation dropped from 77 percent at six months to 37 percent at three years
Other members of the Mayo research team are: Henry Ting, M.D., Victor Montori, M.D., and Amy Wagie. Their work was supported by the Mayo Foundation for Medical Education and Research.