A new study shows that after hospitalization for certain coronary events, a majority of patients are not receiving proper amounts of statin drugs as recommended by national cholesterol guidelines. Looking at records on the medications given to over 65,000 patients hospitalized for heart attacks and unstable angina between 2005 and 2009, UCLA researchers found that fewer than 40 percent of discharged patients were put on the recommended intensive statin therapy. Even for those patients with high levels of “bad” LDL cholesterol levels, only about 50 percent received the intensive drug regimen. According to lead researcher Dr. Gregg Fonarow, whose study was published in the American Heart Journal, many doctors might start patients on less intensive therapy first, and then adjust the doses later depending on the response.
But this is completely backwards from the right approach, says ACSH's Dr. Gilbert Ross. “Physicians should instead start off prescribing the intensive therapy and then look toward possibly reducing the doses later if need be. Patients shouldn’t be started on a low dose that then gets raised.”
Other resistance to intensive therapy comes from certain doctors’ fears that older patients may be more susceptible to some drug side effects such as muscle breakdown. But statins are more important for older patients, says Dr. Dennis Ko, a cardiologist at the Schulich Heart Center at Sunnybrook Health Sciences Center in Toronto.
Placing patients on more intensive therapy earlier decreases their chances of having a future heart attack or dying from a heart-related condition by 20 percent, says Dr. Fonarow.
“This is our opportunity to remind doctors that these are important guidelines that should be put into practice immediately,” says Dr. Ross.