HEART DISEASE: Many Not Getting Cholesterol-Lowering Drugs
Only about one in five Americans who could benefit from cholesterol-lowering drugs is getting them, putting more than 20 million people at risk of heart attack, according to research presented at the annual meeting of the American College of Cardiology in New Orleans. Expressing "one of heart experts' biggest frustrations," Dr. Richard Pasternak of Massachusetts General Hospital, said, "Increasingly we know what to do. The issue is why it's not getting done." Both doctors and patients share blame for the undertreatment, the AP/New Orleans Times-Picayune reports. While only about half of heart attack patients are sent home from the hospital with prescriptions for the medications, patients themselves are "often unenthusiastic" about taking them, either because they underestimate their risk of heart trouble or they are "reluctant to take drugs that don't make them feel better." In addition, the medications are expensive -- about $75 to $100 month -- and there are "lingering concerns" about their safety, although these have been largely put to rest. Finally, some doctors are "slow to adopt new ideas" and "are better paid for treating diseases than for preventing them" (Haney, 3/9).
Less Care for Medicaid
Other findings reported at the meeting:
- Medicaid heart attack patients are significantly less likely to undergo invasive procedures such as coronary bypass surgery, according to a study of 11,500 New York patients in 1995. Study author Dr. Edward Philbin of Henry Ford Hospital reported that the patients were more likely than average to be black and female, but insurance status was correlated with invasive procedures even after those factors were controlled for. Philbin reported that the death rate of Medicaid patients was also higher -- 8.2% vs. 4% among non-Medicaid patients -- and that Medicaid patients also had longer lengths of stay and higher hospital expenses ( Reuters Health, 3/8).
- Researchers from the Henry Ford Heart and Vascular Institute are reporting a heart failure "epidemic," with a new study showing the number of heart failure cases more than doubled at Henry Ford Health System between 1989 and 1997, rising from nine to 20 cases per 1,000 patients (Henry Ford release, 3/8).
- According to a study in this month's American Journal of Public Health, college-educated women are half as likely as less educated women to develop coronary heart disease, which researchers blame on "higher levels of job stress, social isolation, poor coping mechanisms, and lifestyle factors such as smoking, lack of exercise and obesity" (FoxNews/Reuters, 3/8).