Medications to Prevent Heart Attack and Stroke - November 2009

Did you know...

A study conducted by Kaiser Permanente including more than 120,000 patients discovered that patients with diabetes or heart disease could lower their risk of heart attack or stroke by as much as 80 percent, by taking a certain combination of drugs.

Dr. R. James Dudl and his team investigated the combination of a generic statin (lovastatin), a generic blood pressure pill (lisinopril) and low-dose aspirin for patients with a history of heart disease or diabetes.  People with diabetes are two to four times more likely to get a heart attack than people without diabetes, according to the American Diabetes Association.  Similarly, people who have had a heart attack are at high risk of having a second heart attack or a stroke.  In Dr. Dudl's study, people who took these medications most regularly reduced their risk of heart attack or stroke by as much as 80 percent.  Even people who took the medications less than half the time received a 60 percent lower rate of heart attack and stroke.

The medications studied are drugs that have been marketed for more than 10 years, are available in generic form, and are all considered very safe and effective.  They were prescribed at relatively low doses: a statin at a 40 mg/day dose, an "ace inhibitor" blood pressure medication at 20 mg/day, and low-dose aspirin.  This treatment prevented approximately 1,271 heart attacks and stroke in the first year of follow up.

What does CPC recommend?

Many doctors will often start patients at low doses of drugs and gradually increase them in order to find the proper dose that works for the individual.  However, patients who don't see improvement in their blood pressure or cholesterol may instead quit taking the medications.  In this study, a combination of medications started simultaneously proves to be an effective, inexpensive strategy to prevent heart attack and stroke in people who are at high risk.

Heart attack and stroke are the leading causes of death in Americans, and these events often occur unexpectedly.  To protect yourself against heart attack and stroke, you do not have to take expensive, name-brand drugs.  These medications can each cost as little as $4 per month in generic forms.  Take your medications regularly and without exception to get the greatest benefit.  In addition to preventing heart attack and stroke in people who are at high risk, these medications can prevent a first heart attack or stroke.  Talk to your doctor to see if these medications could help you live a healthier life.

This study was published in the American Journal of Managed Care, 2009 Oct 1.