How important is it to take medications after a heart attack?

The purpose of this study was to see how good patients are at actually taking their medications properly after a heart attack. The study also looked at the relationship between taking them properly and further heart attacks and strokes. The main finding of the study was that taking these medications properly reduced the risk of death and further heart attacks and stroke.

Heart disease is the most common cause of death. Treatment for heart attacks and medications used after heart attacks have improved greatly. The purpose of medications that are taken after heart attacks is to prevent further major cardiovascular events such as another heart attack, strokes, and death (MACE). These drugs include cholesterol-lowering drugs, blood-pressure-lowering drugs, beta blockers (BB), which slow the heart rate and anti-clotting drugs.

However, it is not known how good patients are at actually taking their medication. This is called treatment adherence (T-AD). The relationship between T-AD and the MACEs is also not known.

This study included 4349 patients who had been hospitalized for a heart attack. Their T-AD was compared to the rates of MACEs.

A high proportion of patients had very low T-AD to their drugs. 46.7% of patients had low T-AD to their anti-clotting drugs. 23.5% had low T-AD to their anti-cholesterol drugs. 47.3% had low T-AD to their blood pressure medications and 88.1% had low T-AD to their BBs.  

However, patients with high T-AD to anti-clotting medication had a 32% decreased risk of death. High T-AD to anti-cholesterol drugs was associated with a 41% decreased risk of death. High T-AD to blood pressure medications had a 27% decreased risk of death. There was no decreased risk associated with high adherence to BBs. Patients who had high T-AD to anti-cholesterol drugs had a 45% lower risk of MACE.

The authors concluded that taking medications properly after a heart attack, particularly anti-cholesterol drugs, may improve long-term outcomes of patients. However, there is a significant number of patients who do not take their medications.

This study was funded by the industry. The T-AD data was based mostly on the acquisition of the drugs, rather than actual consumption. This might have influenced the results.

If you have trouble remembering to take your medications, talk to your doctor or pharmacist. They may be able to suggest changes to your medications to make it easier for you to remember.