Use of proven heart medicines improves, but not enough

While the use of medicines proven to save the lives of heart patients has shown steady improvement, investigators at the Duke Clinical Research Institute have determined that there is still much need for better physician prescribing of, and patient adherence to, life-saving medicines, particularly continued long-term use of these medicines.

The researchers said that for the most part, physicians and health care providers appear to be doing a reasonably good job of prescribing the appropriate medications to their heart patients at discharge from the hospital. However, the next major challenge is to better understand the factors that influence how consistently heart patients will continue to take their medicines, the researchers said.

The most glaring example highlighted by the researchers is aspirin, which was consistently used by only 71 percent of patients in their study.

"It is eye-opening to be reminded how much work we still have to do when in this day and age, only seventy-one percent of heart patients are taking aspirin," said Duke cardiologist Kristin Newby, M.D., lead author of a study whose results were published online Jan. 9, 2006, in the journal Circulation. "For a drug that is well-understood, inexpensive, easily available and fairly well-tolerated, we should see rates in the upper 90 percent.

"We also found that other drugs that have been proven to save lives are even less consistently used than aspirin, such as beta-blockers, cholesterol-lowering drugs and ACE inhibitors," Newby said. "Our analysis showed that consistent use of these medicines could lead to significant reductions in risk for patients with coronary artery disease."

Specifically, the researchers found that patients who were consistent in their use of aspirin saw a 42 percent reduction in risk of death, while beta-blocker use led to a 37 percent reduction and lipid-lowering medicines led to a 48 percent reduction. Patients who took all three saw a

Contact: Richard Merritt
Duke University Medical Center

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