Chronic Disease

Lifestyle changes are needed in addition to drugs to prevent heart attacks

When factors such as large waistlines, high triglyceride levels, high cholesterol, high blood pressure, and high blood sugar levels work in concert (the so-called metabolic syndrome), they become "perfect storms" for heart attacks. Most of these conditions can be treated with drugs. However, a new study finds that drugs alone do not substantially reduce the risk of a heart attack, largely because patients do not adopt healthy lifestyle changes.

Researchers at the University of Alabama at Birmingham studied 1,125 patients with coronary artery disease who underwent cardiac rehabilitation during two periods, 1996 to 2001 and 2002 to 2006, a period in which guidelines recommended providing medications to get cardiovascular risks under control. Compared with the first period's patients, those in the second period took more medicines and, subsequently, had lower triglyceride levels, cholesterol levels, and blood pressure.

While both groups had similar diets and functional capacities, the second group had lower physical activity levels and larger waistbands than the earlier group, keeping members of both groups at the same risk levels for having heart attacks. The authors suggest that while medication certainly does its part in modifying risk factors, clinicians need to emphasize lifestyle changes, such as increasing exercise, to truly reduce a patient's risk of heart attack. This study was funded in part by the Agency for Healthcare Research and Quality (HS13852).

See "Drugs are not enough: The metabolic syndrome—A call for intensive therapeutic lifestyle change," by Todd M. Brown, M.D., Bonnie K. Sanderson, Ph.D., R.N., and Vera Bittner, M.D., M.S.P.H., in the Winter 2009 Journal of Cardiometabolic Syndrome 4(1), pp. 20-25.

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