November 25, 2003
Physicians Should Prescribe Cholesterol-lowering Medicines
More to Select Patients While Still Hospitalized Study
finds that this could improve quality of life for patients
with cardiovascular diseases
(Philadelphia, PA) - Although cholesterol-lowering agents
have been shown to dramatically reduce the likelihood
of cardiovascular diseases, few people who qualify for
these drugs actually receive them. A study published
in the current issue of Archives of Internal Medicine
suggests that increasing the appropriate use of cholesterol-lowering
therapies – while the patients are still in the
hospital – could translate into improved clinical
outcomes.
Herbert Aronow, MD, MPH, Assistant
Professor of Medicine at the University of Pennsylvania
School of Medicine, and researchers at the
Cleveland Clinic studied more than 2,100 patients at
nearly 70 United States and Canadian hospitals undergoing
heart angioplasty in the EPILOG trial. The researchers
asked the question: ‘If patients with cardiovascular
disease are hospitalized, does it matter whether cholesterol-lowering
agents are begun before discharge or whether that decision
is deferred to the outpatient setting?’ They found
two things: first, patients who started the medicine
while in the hospital fared better than those who didn’t;
and second, those patients who started the medications
while in the hospital were more likely to continue using
the drugs following discharge.
“The bottom line is that we need to capitalize
on the opportunity to initiate these life-saving medications
in the hospital when our patients are most motivated
to alter their lifestyle or medical regimens,”
said Aronow.
“The findings were remarkable,” he continued.
“Patients who were started on cholesterol-lowering
agents while hospitalized were nearly three times more
likely to be taking these medications in follow-up than
those who went home without them. Given the well-established
benefits associated with cholesterol-lowering drugs
and the high prevalence of cardiovascular disease, any
strategy that leads to increased drug utilization could
have a tremendous impact on our societal health.”
Atherosclerosis, the build-up of fatty deposits (‘plaque’)
inside the body’s arteries is the leading cause
of death and disability worldwide. This disease is responsible
for most heart attacks and strokes and ultimately leads
millions of patients worldwide to undergo heart angioplasty
and bypass surgery each year.
“Cholesterol-lowering agents, such as statins,
reduce the chances of dying, having a heart attack or
stroke or needing angioplasty or bypass surgery by roughly
one third,” said Aronow. “Nevertheless,
recent surveys revealed that only one to two-thirds
of eligible patients are prescribed these medications.
Further, among those taking these medications, most
are on too low a dosage to be clinically effective.”
He also cautioned that, “despite the substantial
health benefits attributed to these medications, they
are no substitute for a healthy lifestyle. Diet, exercise
and smoking cessation are the cornerstones of prevention
and should be considered as complementary to, not in
place of, medical therapy.”
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# # #
PENN Medicine is a $2.2 billion enterprise dedicated
to the related missions of medical education, biomedical
research, and high-quality patient care. PENN Medicine
consists of the University of Pennsylvania School of
Medicine (founded in 1765 as the nation’s first
medical school) and the University of Pennsylvania Health
System (created in 1993 as the nation’s first
integrated academic health system).
Penn’s School of Medicine is ranked #2 in the
nation for receipt of NIH research funds; and ranked
#4 in the nation in U.S. News & World Report’s
most recent ranking of top research-oriented medical
schools. Supporting 1,400 fulltime faculty and 700 students,
the School of Medicine is recognized worldwide for its
superior education and training of the next generation
of physician-scientists and leaders of academic medicine.
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its flagship Hospital of the University of Pennsylvania,
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Roll” hospitals by U.S. News & World Report),
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three multispecialty satellite facilities, and home
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