When should prescription drugs for heart disease be used?
This article is part of Health Divide: Heart Disease Risk Factors, a destination in our Health Divide series.
Verywell Health: When should you consider prescription drug intervention to help prevent heart disease?
Dr Velarde: When honest efforts to incorporate lifestyle changes have not yielded the desired results, medication can and should be considered.
It starts with setting specific goals for specific risk markers (eg, blood pressure measurement) and performing basic lifestyle interventions for them. If after three to six months of lifestyle changes you haven’t reached your target or goal, it’s time to intervene with medication.
However, it is essential that patients know that there is no fixed period for lifestyle changes. They should not be given up because you start taking medication. Lifestyle changes must be made for life, whether or not the patient is taking medication.
Unfortunately, this message is not always heard by patients. They may think that once they take medication, they can unleash their food choices or their commitment to exercise. This is not the case. The goal is to first give an honest effort to lifestyle changes, then if goals have not been met, begin a prescribed drug regimen.
This is particularly the case for blood pressure. For example, we know that nearly half of the US adult population (47% or 116 million) has high blood pressure, and about two-thirds of them need more than two medications to control it. So what’s the point of taking a pill or two if there isn’t a good basis for life first? Patients often fail to do what is necessary – the basic effort of their lifestyle – to control their blood pressure with medication.
In many cases, basic lifestyle commitments are broken or abandoned. The reasons for this are complex but constitute obstacles that we must identify and overcome. Medication adherence also often involves cost, access to care, and lack of awareness of the impact of risk factors if left untreated. But failing to make the necessary basic lifestyle changes is an extremely important first step.