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Health & Fitness

WHEN DO YOU STOP TAKING YOUR HEART MEDICATIONS?

Cardiologists warn that 'Too many drug types are compromising heart health'.

Once you start blood pressure medicine, (or cholesterol, blood thinners, beta blocker meds and many more) you will take it for the rest of your life.  Right? 
Well… Over the years, we have made some basic assumptions regarding some of our medicines….and it turns out that we’re not simply wrong… but we may be doing more harm than good.

In a 3-13-2013 Reuters article titled, Too many drug types are compromising heart health: doctors,    Debra Sherman writes:

About 80 million Americans suffer from heart disease, the nation's No. 1 killer, and most are on multiple drugs.  Some cardiologists think prescribing has gotten out of hand.

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The criticism was voiced by a number of leading heart doctors who attended the annual scientific sessions of the American College of Cardiology, held on March 9-11 in San Francisco. They said eliminating certain drugs could potentially improve care without compromising treatment. Evidence is growing that some medications are not effective.

'EAGER TO ADD, RELUCTANT TO TAKE AWAY'

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A person who has had a heart attack typically leaves the hospital on a beta-blocker to slow the heart, an ACE inhibitor to reduce blood pressure, clopidogrel and aspirin to thin the blood and prevent clots, and a statin to reduce cholesterol, said Dr. Micah Eimer, a cardiologist with Northwestern Medicine in suburban Chicago.

"That's a minimum of five medications, and each one has a proven mortality benefit. It's practically malpractice if you don't prescribe those," Eimer said. "But we have no data on when it's advantageous to take (patients) off."

Many patients are on many more drugs, according to research by Dr. Harlan Krumholz, a Yale University professor of cardiology and public health. Using Medicare data, he found that heart failure patients, those whose hearts are too weak to pump blood sufficiently, were prescribed an average of 12 drugs; some were on 30.

"We are eager to add medicines and reluctant to take them away," said Krumholz.

BLOCK THAT BLOCKER?

Beta-blockers are absolutely necessary for some patients, said Dr. Sripal Bangalore, a cardiologist at New York University, but are probably prescribed too widely and for too long a period of time. Examining three distinct patient groups from a data registry of 44,000 patients, he said the drug did not reduce the risk of heart attack, stroke or death after 3.5 years.

Dr. Richard Stein, a professor of medicine at New York University and spokesperson for the AHA, estimated the average patient with heart disease truly needs to take from seven to nine pills each day in order to control the various risk factors, including cholesterol, high blood pressure and diabetes. Beyond that, he said, it makes sense to be restrictive.

 

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