There is considerable controversy about the value of statins for preventing initial heart attacks. Some physicians are convinced that these drugs are extremely useful, while others point out (as in this editorial in JAMA Internal Medicine) that the data supporting that stance are weak. Almost no one disputes the importance of these cholesterol-lowering drugs for stroke or heart attack patients after such a serious event.
How Well Do Heart Attack Patients Take Their Statins?
A new study finds, however, that many heart attack patients do not follow through on taking high-dose statins afterwards. The investigators analyzed data for almost 60,000 Medicare patients. All of them had received a prescription for either atorvastatin (Lipitor) or rosuvastatin (Crestor). They were interested in “adherence,” a medical term for how well patients continue taking their medications.
Many People Stopped Taking Their Statins:
Despite the high stakes, within two years fewer than half of these heart attack patients were still taking their statin at the prescribed dose. This study was not designed to discover why, so the reason for such dropouts remains unclear. People who had more cardiologist visits after their hospital discharge and those who participated in cardiac rehabilitation did better. Perhaps this reinforcement is important.
Why? We Don’t Know:
When it comes to explaining why people may drop their medication, cost and side effects may play roles. Many people report muscle pain or weakness and some complain of “brain fog” when they are taking statins. Addressing these concerns rather than dismissing them might help. We will look forward to a future study that explains why heart attack patients stop their statins.