A pounding heart may be dangerous for some kidney patients

January 13, 2011, American Society of Nephrology

Among older adults with a recent heart attack (myocardial infarction), those with lower levels of kidney function are less likely to take their medications as prescribed, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

"Several types of medications have proven benefit for preventing recurrent heart attacks, yet only about half of people with heart disease take their medications correctly," comments Wolfgang C. Winkelmayer, MD, ScD (Stanford University School of Medicine, Palo Alto, CA). "Adherence was lower in patients with more pronounced kidney dysfunction."

The researchers studied 2,103 patients aged 65 or older with a recent heart attack. Pharmacy insurance claims records were used to determine the percentage of days that patients actually had their prescribed medications.

The results showed low long-term adherence rates for three major classes of heart medications: angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (ACEIs/ARBs), beta-blockers, and . Over three years' follow-up, the patients had their prescribed drugs for only 50 to 60 percent of the time.

For ACEIs/ARBs and beta-blockers, was significantly lower for patients who had lower levels of at the beginning of the study. Adherence to statin drugs was not significantly related to kidney function.

"Since poor medication adherence increases the risk of hospitalization and death, it is important to understand the scope of the problem," Winkelmayer explains. In a previous study in the same group of patients, the researchers found low medication adherence rates within the first 90 days after . "In the current study, we wanted to extend these findings to examine long-term outpatient medication adherence, particularly in patients with , who are at high risk for recurrent heart attacks but who have not been studied extensively to date." "Future strategies to improve medication adherence and clinical outcomes will need to pay special attention to this high-risk population."

The study had some important limitations. Kidney function was measured based on a single lab test performed in the hospital, which may underestimate the true baseline kidney function. The study included a sample of elderly, low-income patients with a high proportion of whites and women, so the results may not be applicable to a more diverse population. Also, since medication adherence was measured using insurance claims data, the researchers were unable to determine why patients weren't following their prescriptions. "For example, the medication may have been purposely discontinued by the treating physician due to unwanted side effects," says Winkelmayer.

More information: The article, entitled "Kidney Function and Long-Term Medication Adherence after Myocardial Infarction in the Elderly" (doi 10.2215/CJN.07290810), will appear online on January 13, 2011.

Related Stories

Recommended for you

Flu may be spread just by breathing, new study shows; coughing and sneezing not required

January 18, 2018
It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

New study validates clotting risk factors in chronic kidney disease

January 17, 2018
In late 2017, researchers from Boston University School of Medicine (BUSM) discovered and published (Science Translational Medicine, (9) 417, Nov 2017) a potential treatment target to prevent chronic kidney disease (CKD) ...

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

Newly-discovered TB blood signal provides early warning for at-risk patients

January 17, 2018
Tuberculosis can be detected in people with HIV infection via a unique blood signal before symptoms appear, according to a new study by researchers from the Crick, Imperial College London and the University of Cape Town.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.