Medicines for heart disease don’t rule out the need for lifestyle changes

People with heart disease are taking more drugs to control the condition but not improving their lifestyles to match, a big survey has found.

The benefits of drugs may be cancelled out by risk factors like being overweight, having diabetes and smoking, say the researchers. They say doctors should do more to encourage people to change their lifestyles in order to reduce the risk of heart attack.

What do we know already?

There are lots of ways that people at risk of a heart attack can stay healthy and improve their chances of avoiding heart problems. These include taking medicines to manage cholesterol levels and blood pressure and lower the chances of getting a blood clot. But other things have a big influence as well.

These include smoking tobacco (smoking stiffens your blood vessels) and being overweight (this can increase your cholesterol levels and your blood pressure). Having diabetes also increases your chances of getting heart problems. Some people with diabetes get it because they are overweight and don’t take enough exercise – although that’s not true of all people with diabetes.

Back in 1996, researchers started a series of big, regular surveys of thousands of people with heart disease, in a number of European countries. They looked at people’s weight, blood pressure, cholesterol level, whether they smoked or had diabetes, and what medicines they took. The researchers now have the latest figures from the 2006/2007 survey, which they can compare with earlier surveys done in 1996/1997 and 1999/2000.

What does the new study say?

The survey found that during this time, rates of diabetes and obesity increased among people with heart disease. The proportion of heart patients who smoke, and the proportion who have high blood pressure remain unchanged. The only risk factor for which rates have fallen is raised cholesterol.

Tell me more about the study’s findings

These are the main findings from the latest survey, compared to 1996:

• The proportion of people with heart disease who smoked stayed about the same, at 18 percent
• The proportion who were obese (very overweight) went up, from 25 percent to 38 percent
• The proportion of people with diabetes went up, from 17 percent to 28 percent
• People were much less likely to have high cholesterol. This went down from 95 percent to 46 percent of people. That’s probably because so many people now take statin drugs to reduce cholesterol
• The proportion of people with high blood pressure stayed about the same, at 61 percent.

How reliable are the findings?

The findings are likely to be reliable. This is a big, well-run study. However, none of the patients studied came from the UK, so we don’t know exactly how relevant the results are to this country.

Where does the study come from?

The study was co-ordinated by doctors from universities in the UK, Belgium, Finland and Germany. The countries studied in this paper were the Czech Republic, Finland, France, Germany, Hungary, Italy, the Netherlands and Slovenia. It was published in The Lancet medical journal, owned by a publishing company called Elsevier.

What does this mean for me?

While drugs can help people with a heart problem, they’re not enough on their own. Making an effort to stay healthy, by watching your diet, taking exercise and giving up smoking, can make a big difference to your chances of avoiding a heart attack.

What should I do now?

If you want to make changes to improve your heart health, but you’re not sure where to start, make an appointment to see your GP or practice nurse. They can help you make a plan to improve your lifestyle.