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The Heart of the Matter

I promise that I am not going to get up on my soap box about diet and exercise and all the health benefits owing to not sitting around so much.  I have a different soap box today.  Doctors often refer to this problem as nonadherence, but we also more commonly talk about noncompliance.  You often see this on the label of a medication: “Take as directed.”  That means two things, and the first is don’t take more or less of it and don’t take it more or less frequently.  It also means just plain take it.

Only in baseball is it considered really outstanding to have small percentages of success like a batting average that is .250 to .330.  (That translates into getting on base 25% to 33% of the times a player is at bat.)  But when it comes to taking statins, the numbers are really low.  In a study of 5500 patients presented recently at an American College of Cardiology conference recently, researchers followed the adherence of patients who recently had had a heart attack and who had been prescribed a statin to reduce their low (bad) cholesterol.

These were “typical” heart attack patients with an average age of 57 years, and 80% of them were male.  As the researchers followed these patients they discovered that 25% did not fill the prescription the doctor gave them.  And another 25% did not refill their prescription the next time it was due … but it gets worse.  Only a bit over 6 percent of the patients took the medication as it was prescribed 80 percent of the time.  The small group who took their statins “as directed” had a 48% lower incidence of another heart attack.

This matters even more for your older loved one.  As a matter of practice, a fair number of doctors take their patients off a statin when they get to their mid-seventies.  Doctor must know best, right?  But a European study of over 120,000 people over age 75 has shown that stopping statin therapy is a bad idea.  As researchers followed these people the group who went off statins had a 46% greater likelihood of a coronary event like a heart attack and a 26% increased chance of a stroke.

And this is why I am raising this issue today, because we are Aging Life Care Advisors.  I am not setting aside diet and exercise, but I want to underscore that if your older loved one’s doctor prescribes a statin, pester them about taking it.  It does make a difference.

Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.


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