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Pharmaceuticals as an excuse, not treatment

Posted Jan 11 2009 3:06pm

Should doctors prescribe pharmaceuticals to patients who have heart disease.  Statins and ACE inhibitors are frequently prescribed to patients with cardiovascular problems.  These medications have been shown to decrease the risk of heart attack in clinical trials, but could they actually increase the risk of a heart attack in the real world?

The answer is yes if taking the drugs changes behavior.  Without any pharmaceutical treatment, patients with a family history of a heart attack may decide to exercise more and eat healthier. Once the patient starts taking the pharmaceuticals, however, this may give them less of incentive to take care of themselves.  The drug can give them an excuse to engage in an unhealthy lifestyle.

 ”Yeah, I’m still smoking and eating philly cheesesteaks  for breakfast, but I’m taking a statin so I’ll be fine.”  It is true that clinically statins reduce the risk of heart attack.  If heart medications also produce a sense of false security and adversely affect patient lifestyle behaviors, then prescribing these medications may actually be counterproductive.

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