Preventive heart meds: Cheap and under-used

Cardiovascular disease affects more than 100 million people worldwide, yet the inexpensive drugs that could lower the risk for recurrence of these life-threatening illnesses are not getting to the majority of patients who need them. A study just published in The Lancet has found that about 60 percent of people with heart disease, and up to half of those who have had a stroke, are not taking a blood thinner like aspirin, a cholesterol-lowering statin, or one of two types of vessel-protecting medications known as beta-blockers and ACE inhibitors, or ARBS.

These findings are disconcerting not only because such medications play a preventive role, but because their underuse is most prevalent in low-income countries where the majority of the world s heart disease and stroke cases occur. In the largest clinical study to date, researchers from McMaster University in Canada found that, in those poorer countries, about 80 percent of people with a history of heart disease or stroke take none of these drugs. The study encompassed 154,000 adults from 17 countries as disparate as Canada and Zimbabwe. And, while use of these preventive medications was substantially higher in wealthier countries, the numbers were still not where they should be.

Lead author Dr. Salim Yusuf called these findings a global tragedy and said the study demands a re-thinking of cardiovascular healthcare policy. He urged nurses to play a larger role in order to promote more widespread use of the appropriate medicines especially, he says, because improvements to the uptake of effective secondary prevention strategies are probably more feasible than lifestyle modifications in primary prevention.

ACSH s Dr. Gilbert Ross agrees: Given the huge toll of cardiovascular disease worldwide, greater effort needs to be expended by public health officials as well as primary care physicians to ensure that more patients get these simple, often cheap, and generally safe medications most especially in poorer countries, but even here in the U.S.