Heart attack survivors fall through medicine cracks

Less than one-third of people who survive a heart attack are taking protective medications 12 months later, according to new Australian research based on data from the Sax Institute’s 45 and Up Study.

Researchers from the George Institute in Sydney analysed medication use in 14,200 people who were hospitalised for a first heart attack, focusing on two medications that lower blood pressure and cholesterol levels, as both are recommended by current guidelines.

While they found that overall, nearly 30% of participants were still taking both medicines after 12 months, that number dropped to just 7% for survivors who weren’t on either of the medications before their heart attack.

For those already taking both medications before their first heart attack, the researchers found around two-thirds were still compliant after 12 months – an almost 10-fold increase compared with those new to the drugs.

Prior medication use had the strongest impact on whether people took both medicines after their heart attack, even after adjusting for age, sex, education and income. The researchers said the next step is to understand exactly why people aren’t being prescribed or aren’t taking recommended medicines after a heart attack.

Why taking tablets matter

Lead author Dr Anna Campain, Biostatistician at The George Institute and Conjoint Lecturer in the Faculty of Medicine at UNSW Sydney, said the results suggest paying attention to what medications a patient was on before the heart attack is crucial when discharging them from hospital.

“Specialists, pharmacists and GPs should focus more on supporting patients who are taking these medications for the first time,” she said.

Cardiovascular disease is the leading cause of death globally, despite considerable advances in effective preventive treatments. Heart attacks – or acute myocardial infarctions – account for almost half of these deaths.

In Australia, 7,300 people died from a heart attack in 2018, which translates to 20 deaths a day. Having one heart attack greatly increases the risk of having another, but this risk can be halved with the correct treatment and management.

Senior author and study instigator Professor Meg Jardine of The University of Sydney said the findings are significant because previous research had focused on medication use at the time of a first heart attack.

“We were able to take a much broader view in this research by drawing on information before, during and after the time of a first heart attack,” she said.

“A heart attack is a traumatic and life-changing event, but it may be only one factor in driving behaviour change,” said co-senior author, Professor David Peiris of The George Institute.

The 45 and Up Study is an Australian population-based cohort study of over 267000 men and women aged 45 years or over who were randomly sampled from the general population of New South Wales.

Find out more

  • Access the full paper here
  • Find out more about the Sax Institute’s 45 and Up Study here