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Heart Disease and Stroke

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Use of cholesterol-lowering drugs by elderly heart attack survivors has increased substantially since the mid-1990s

Use of statin and other drugs to lower cholesterol levels among heart attack patients has been shown to improve their survival and reduce the risk of further heart problems. The good news is that in 1999 and 2000, nearly 60 percent of elderly heart attack survivors in three different areas of the United States were using cholesterol-lowering drugs 5 years after having a heart attack. This is far more than the 12 to 29 percent of elderly heart attack survivors shown to be taking these medications in previous studies during the mid 1990s. This finding suggests the positive impact of acute myocardial infarction (AMI, heart attack) care guidelines and educational campaigns on the benefit of these drugs among elderly heart attack survivors.

On the other hand, only one-third of these elderly patients knew their cholesterol level, and many were unaware of the potential adverse effects of cholesterol-lowering medications. Clearly, elderly heart attack survivors could benefit from increased education about cholesterol testing and treatment, concludes John Z. Ayanian, M.D., M.P.P., of Brigham and Women's Hospital and Harvard Medical School. In a study that was supported in part by the Agency for Healthcare Research and Quality (HS08071), Dr. Ayanian and his colleagues conducted a telephone survey of 815 elderly Medicare patients in 1999 and 2000. The patients had been hospitalized for heart attacks 5 years earlier.

Nearly 60 percent of respondents said they were taking cholesterol-lowering drugs. However, only 24 percent were aware that cholesterol-lowering drugs can cause hepatitis, and only 4 percent were aware those drugs can cause muscle damage. Women, those aged 65 to 69 years, and those who said a cardiologist was mainly responsible for their cholesterol management were more likely to be taking cholesterol-lowering drugs. Although 77 percent of respondents said that lowering their cholesterol level was very important after AMI to prevent another AMI, only 33 percent knew the results of their own cholesterol test conducted within the previous 2 years.

See "Use of cholesterol-lowering therapy by elderly adults after myocardial infarction," by Dr. Ayanian, Mary Beth Landrum, Ph.D., and Barbara J. McNeil, M.D., Ph.D., in the May 13, 2002 Archives of Internal Medicine 162, pp. 1013-1019.

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