Healthy lifestyle changes slide back after starting Statins, BP drugs: JAHA Study
Finland: Initiation of antihypertensive and statin medication is associated with lifestyle changes, some favourable and others unfavourable, a recent study in the Journal of the American Heart Association has indicated.
This suggests that expansion of pharmacologic interventions may not necessarily lead to expected benefits in people at low risk of cardiovascular disease (CVD). The researchers call for more effective strategies to encourage lifestyle changes in patients beginning preventive medications. They cite U.S. guidelines, which recommend cognitive-behavioural methods, multidisciplinary approaches, and consideration of the individual's social determinants of health.
Lifestyle modification is a key component of cardiovascular disease prevention before and concurrently with pharmacologic interventions. Whether and how the initiation of preventive medication affects lifestyle remains unclear. Maarit J. Korhonen, Department of Public Health, University of Turku, Finland, and colleagues evaluated whether lifestyle factors change in relation to the initiation of antihypertensive or lipid‐lowering medication (statins).
For the purpose, the researchers studied 41 225 Finnish adults aged 40 and older (84% women) who were free of cardiovascular disease at baseline. The participants completed multiple lifestyle questionnaires from 2000 through 2013, and pharmacy records were examined to identify the start of antihypertensive or statin therapy.
Using a series of pre–post data sets, the researchers compared changes in body mass index, physical activity, alcohol consumption, and smoking between 8837 initiators and 46 021 noninitiators of antihypertensive medications or statins.
Key findings of the study include:
- In participants who initiated medication use, body mass index increased more and physical activity declined compared with noninitiators.
- The likelihood of becoming obese (odds ratio: 1.82; 95% CI, 1.63–2.03) and physically inactive (odds ratio: 1.08) was higher in initiators.
- Medication initiation was associated with greater decline in average alcohol consumption (−1.85 g/week) and higher odds of quitting smoking (odds ratio for current smoking in the second survey: 0.74).
"More effective measures are needed to support the recommended lifestyle change in relation to the initiation of pharmacologic interventions for primary prevention" wrote the authors.
The study, "Lifestyle Changes in Relation to Initiation of Antihypertensive and Lipid‐Lowering Medication: A Cohort Study," is published in the Journal of the American Heart Association.
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