Inexpensive drug duo, lovastatin/cholesterol & lisinopril/blood pressure lowers heart attack risk

[steven johnson]

The initial event in heart attacks is a plaque rupture. Atherosclerotic plaques are deposits of fatty material in the walls of arteries with thin membranes over them that can rupture (break open) causing a thrombus or blockade of the vessel. The likelihood of this rupture is much greater with inflammation. Fish oil, aspirin, lisinopril and lovastatin, all of which decrease inflammation, have been shown to significantly reduce stroke and heart attack rates.

Aspirin does have bleeding side effects and some caution is warranted if you don't have significant risk factors for heart attacks or strokes.

Fish oil may protect against stroke

Aspirin Therapy: Right for Your Heart?

An inexpensive combination of one drug to lower cholesterol and one to lower blood pressure can reduce the incidence of heart attacks and strokes by as much as 60% -- but getting patients to begin the regimen and then to stay on it is an extremely difficult task, Kaiser Permanente researchers reported Thursday.

The Kaiser team chose two generic drugs, lovastatin for cholesterol and lisinopril for blood pressure, and offered them to 170,000 members of their managed-care programs in Northern and Southern California who suffered from heart disease or diabetes.

They began the program in 2004 with nearly 70,000 patients. The team monitored compliance for two years by checking whether and how often patients refilled their prescriptions, then monitored health effects in the third year through the patients' health records...47,268 patients ...termed "low exposure" to the drugs, taking them less than half the time...risk of hospitalization for heart attack or stroke was lowered by 15 events per 1,000 person-years..."high exposure" to the drugs, taking them more than half the time...risk was reduced by 26 events per 1,000 person-years...


"What was fairly amazing to me was that we got such a good drop in heart attack and strokes" despite the low adherence, Dudl said. "The issue now is how to increase adherence."

Text

[orpupilofnature57]

1. Sorry ,I hear Kaiser Permanente and I don't get a confident feeling of

hope,they and Trickie Dick got us in this mess ,or at least got thee ball rolling. http://www.ask.com/bar?q=History+of+HMO+Act+of+1973&page=1&qsrc=6&ab=0&u=http%3A%2F%2Fwww.bestsyndication.com%2F2005%2FNicole-WILSON%2F081005-HMO-Plan-History.htm

[steven johnson]

5. Kaiser won a national quality award for this

"The HMO giant won a national award in 2006 for its ALL (Aspirin-Lisinopril-Lovastatin) Initiative, a program that is estimated to have prevented some 3,400 heart attacks and strokes among its Northern California members between 2004 and 2006, according to Richard Harr, M.D., a Roseville-based internist and chief of Kaiser Permanente's North Valley Chronic Conditions Management program... It seems to be working: Kaiser Permanente's Northern California members are estimated to have a 30 percent lower risk of dying from heart disease than the general public."

http://www.sacmag.com/media/Sacramento-Magazine/April-2008/In-Good-Hands/

[Epiphany4z]

2. kaisers drug formulary sucks

it's very restrictive.

Lovastin..can be hard on the liver...i know mine sure didn't like it.

[Warren Stupidity]

4. statins don't work for everyone because of side effects

I think the choice was price based - there are plenty of other statins to choose from, but most are quite expensive. As far as I know, and I am certainly not an expert, they all have about the same good effect on cholesterol.

[MannyGoldstein]

3. Great stuff - but the link is broken

Cheap, safe drugs.

[steven johnson]

6. My bad, try this link

http://www.latimes.com/news/nationworld/nation/la-sci-drugs3-2009oct03,0,2865375.story