Among all the patients, the proportion of patients taking each agent and combinations of agents increased over the time of the study, with the peak for each occurring in 2002. |
Native Americans have a lot more cardiovascular disease than the population in general, but what we don't know is how much of their increased risk is due to their genetic background and how that background is modified by Western lifestyles and environmental factors. |
Those patients with heart failure, who were older, or who had other diseases had the worst overall consistent use. There are still doctors who are reluctant to prescribe these drugs to their sickest patients, maybe not realizing that potential side effects are far outweighed by the benefits. This represents a gap in our understanding – why is it that health care providers appear to fear treating these patients as aggressively as other patients? |
We also found that other drugs that have been proven to save lives are even less consistently used than aspirin, such as beta-blockers, cholesterol-lowering drugs and ACE inhibitors. Our analysis showed that consistent use of these medicines could lead to significant reductions in risk for patients with coronary artery disease. |
We as physicians have spent a great deal of time studying how best to treat our patients while in the hospital, so now we need to focus on better understanding the barriers to improved compliance outside of acute medical settings. This will be a much more difficult problem, since it involves so many different factors. |