Adherence to drug treatments prolongs survival after heart attack

doi:10.1136/bmj.39093.538542.80

BMJ 2007;334:118 (20 January), doi:10.1136/bmj.39093.538542.80

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Adherence to drug treatments prolongs survival after heart attack

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People who keep taking their heart disease tabletsas directed tend to do better than people who don't. Is thisimproved prognosis a result of the drugs or do people who diligentlytake tablets tend to be healthier in general than people whowon't, or can't? To find out, researchers studied a large cohortof survivors of heart attack from Ontario who were dischargedfrom hospital with prescriptions for a statin, a $beta$ blocker, ora calcium channel blocker

After a median follow-up of nearly two and halfyears, the authors found a clear link between worsening adherenceand increasing risk of death for statins and $beta$ blockers, drugsthat improve survival after a heart attack. No such link wasseen between death and adherence to calcium channel blockers,which don't improve survival. The authors infer that patientswho take their tablets live longer because of the biologicalaction of the drugs not the so called "health adherer effect."

To test their hypothesis further the researchersalso looked for associations between poor adherence to the heartdrugs and admissions for cancer—a link you might expectto find if poor adherence was associated with unhealthy lifestyles.They found no associations between adherence and cancers ofthe lung, breast, or prostate.