Drugs Drive Dip in Heart Attack Deaths

March 27, 2007 (New Orleans) -- Heart attack patients are more likely to survive for years longer than in the past, thanks to increased use of potent heart medications that control long-term risks, researchers report.

Growing use of cholesterol-lowering statin drugs and high blood pressure drugs helped to lower death rates among heart attack patients by a significant 3% per year from 1995 to 2004, says Soko Setoguchi, MD, a researcher at Brigham and Women's Hospital in Boston.

Cardiovascular disease is still the No. 1 killer in the United States, and 865,000 people have a heart attack each year. But the new findings show that drug therapy can make a difference, says Douglas P. Zipes, MD, director of cardiology at Indiana University School of Medicine in Indianapolis.

“While death rates are going down, a worsening tide of obesity, inactivity, and diabetes are all contributing to an increased risk of having a heart attack,” says Zipes, who was not involved with the study.

“The new findings emphasize the importance of pharmacological regimens,” he tells WebMD. “Patients should take their medications as prescribed by their cardiologists because there are very real benefits, including living longer.”

The study was presented at the annual meeting of the American College of Cardiology.

Use of Statins, High Blood Pressure Drugs Up

For the study, Setoguchi and colleagues tracked nearly 22,000 people who were hospitalized for a heart attack between 1995 and 2004 and survived at least 30 days after discharge. They were followed for an average of 3.5 years, during which time about half of them died.

Analysis of pharmacy records showed that the use of heart drugs also increased during the study period:

• The use of statin drugs rose from about 8% in 1995 to 45% in 2004. Statins treat high cholesterol and include drugs such as Crestor, Lipitor, Pravachol, and Zocor.
• The use of beta-blockers, which include drugs such as Coreg and Toprol-XL, rose from 41% in 1995 to 65% in 2004. They help the heart relax, slow the heart rate, and lower blood pressure, thereby boosting the heart's pumping ability over time.
• The use of angiotensin-converting enzyme (ACE) inhibitors such as Altace and Captopril and angiotensin II receptor blockers (ARBs) such as Diovan increased from 40% to 45%. These drugs are widely prescribed to patients following heart attacks and for those with heart failure. They are high blood pressure drugs, which work by preventing blood vessels from narrowing, making it easier for blood to flow through the vessels and alleviating the workload on the heart.

Drugs Boosting Survival

When the researchers took drug therapy into account, the decrease in deaths over time was entirely eliminated. “This suggests that the change in survival is primarily attributable to increased use of recommended drugs,” Setoguchi says.

More heart attack survivors also underwent angioplasty and stenting to prop up blocked heart arteries over time, she says.

When the researchers took those figures into account, the reduction in deaths diminished but wasn’t entirely eliminated, Setoguchi says. “The increased use of angioplasty and other interventions couldn’t explain the improvement in long-term survival,” she tells WebMD.

That may be because the researchers only looked at heart attack patients who survived their hospital stay. Another analysis, which looked at death rates among heart attack patients during hospitalization, showed that an increased use in angioplasty accounted for a similar rise in early survival rates, she says.

Because many people in the study were on more than one medication, Setoguchi says the researchers couldn’t determine the relative impact of each type of drug on survival rates.