Patients lag in adhering to heart therapy

Introducing antihypertensive and lipid-lowering medications at the same time improved patients' generally poor compliance, according to a new study.

By Susan J. Landers, AMNews staff. June 13, 2005.

Washington -- A more difficult problem than diagnosing people at risk for cardiovascular disease might be getting them to take their medicine to address it.

It's a huge problem, several physicians acknowledged. "I think that nonadherence to medical therapy is one of the greatest challenges we face in cardiology," said Lori Mosca, MD, PhD, MHP, director of preventive cardiology at New York Presbyterian Hospital.

Christie Ballantyne, MD, director for cardiovascular disease prevention at Baylor College of Medicine in Houston, won't ever forget his conversation with one patient, a lawyer, in the coronary care unit.

When the patient, who had just had a heart attack, was asked why he wasn't taking the statins prescribed three months earlier, he responded, "Doc, did you ever read all the side effects?"

Cardiovascular disease accounts for at least 930,000 deaths a year, and physicians have the tools to help reduce that toll.

Lipid-lowering statins and the range of antihypertensive drugs available have been proven to reduce cardiovascular risk. But they do no good if patients don't take them.

Now comes a new study that confirms physicians' fears.

Within six months of receiving prescriptions for a lipid-lowering medication and an antihypertensive drug, only one in every three people is still likely to be taking both medications. The study appeared in the May 23 issue of the Archives of Internal Medicine.

Researchers found that compliance with treatment already had begun to decline sharply within three months and continued to decline for a year, after which adherence generally stabilized.