Half of heart attack patients stop taking lifesaving medications within three years

Recovery from heart attacks is best served by continuing to take prescribed medications.

Yet more than half of patients who have had a heart attack stop taking these lifesaving medications within three years, according to results from a Mayo Clinic study presented today at the American Heart Association's Scientific Sessions 2007 in Orlando, Fla.

The Mayo data also show that in the short term, smokers are more likely to discontinue taking all of their prescribed heart medications, whereas in the long term, data show that patients enrolled in cardiac rehabilitation programs tend to continue their medications at a higher rate than patients who do not enroll. The researchers suggest their data support a two-pronged strategy for improving the public's heart health: 1) target heart patients who smoke for education on complying with physicians' aftercare advice about continuing medications, and 2) encourage all heart patients to participate in a cardiac rehabilitation program, possibly increasing their likelihood of continuing prescribed treatments.

Significance of the Mayo Clinic Research

The study was designed to improve recovery and quality of life after heart attack by determining how well patients comply with physicians' recommendations. “It 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.

By following patients at six, 12 and 36 months after a heart attack, the researchers discovered that smokers are most likely to stop taking their medication, placing them at increased risk for more heart attacks and complications, says Dr. Shah. “This suggests that current smokers may be a target group for education acute heart attack. Participation in cardiac rehab programs seems to be another important factor associated with long-term continuation of prescribed medication therapy,” he says.

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.

About the Study

In their study, the Mayo researchers evaluated 292 patients, a subset of all the patients who were enrolled in the Olmsted County, Minn., registry of acute heart attacks. This subset also had prescription drug claims data available from another source. The team looked at long-term data (up to 10 years) for patients who had heart attacks and who were discharged from the hospital and 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.

Collaboration and Support

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.