Cheap three-drug combination helps cut heart risks

High-risk patients who took a combination of three older heart drugs—a generic cholesterol-lowering statin, a generic blood pressure pill and a low-dose aspirin—cut their risk of a heart attack or stroke by as much as 80 percent, U.S. researchers said on Thursday.

They said their study offers a simple, effective and inexpensive way to help people with diabetes or heart disease avoid heart attacks and strokes.

“Even in people who took it less than half the time, they got over a 60 percent drop in heart attacks and strokes,” said Dr. R. James Dudl of Kaiser Permanente in California, whose study was published in the American Journal of Managed Care.

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By Julie Steenhuysen

CHICAGO (Reuters)

“Those who took it more than half the time—they got more like an 80 percent drop,” Dudl said in a telephone interview.

The study set out to offer a uniform approach to preventing heart attacks and strokes in people with heart disease or diabetes. Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes, according to the American Heart Association.

Several recent large studies found that aggressive efforts to control blood sugar do little to prevent heart attacks and strokes in diabetics.

Researchers at Kaiser Permanente followed 68,560 people with diabetes or heart disease who each day took the drug combination, consisting of 40 milligrams of the cholesterol fighter lovastatin and 20 milligrams of the blood pressure pill lisinopril for two years. People were also encouraged to take a low-dose aspirin.

The treatment prevented 1,271 heart attacks and strokes in the first year of follow up, Dudl said.

By checking prescription records, they were able to see which patients took their drugs most frequently. They found that even when people took their medications only 22 percent of the time, they had a 60 percent drop in heart attacks and strokes.

Dudl said many doctors like to start patients out with lower doses of drugs and gradually increase them to find the ideal dose for each patient, but often people who do not see results right away stop taking their medications.

“This is a proven program that can be applied in many settings to reduce heart attacks and strokes, and at the same time decrease the cost of care for those events,” Dudl said.

It also suggests that people do not need to take a name-brand statin drug—which Dudl said costs up to eight times more than a generic—to achieve a major reduction in risks.

Although in the study the team used lovastatin, the generic name for Merck’s Mevacor, Dudl said the team now recommends Merck’s Zocor, or simvastatin—which has been shown to be a more effective statin—as part of the three-drug regimen.

SOURCE: American Journal of Managed Care, online October 1, 2009.