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Heart attack patients following medical advice live longer


According to a new study, patients who followed medical advice after a heart attack were more likely to survive years after their heart attack. Their prospects improved with every additional recommendation they followed.

The study was published in the Journal of the American Heart Association.

The study was conducted in Kaiser Permanente Northern California, which has about 4.4 million members who are broadly representative of the area’s population. The study assessed how many recommendations patients were following at 30 and 90 days after their heart attacks and examined the association between adherence and survival in the years following the heart attack.

Recommendations included taking four cardiovascular medications, not smoking, and achieving blood pressure and cholesterol control. The study followed patients for an average of 2.8 years after their heart attack.
Mortality was reduced by as much as 43% among the most conscientious patients who were tracked.

Researchers found high compliance with individual components of post-heart attack medical advice among Kaiser Permanente patients ranging from 67 per cent taking prescribed non-aspirin antiplatelet drugs to 88 per cent taking high cholesterol medications at 30 days. Patterns were similar at the 90-day mark. About one-third of patients followed at least 5 of 6 recommendations at 30 days and at least 6 of 7 recommendations at 90 days.

“Our findings support the value of comprehensive secondary prevention efforts such as cardiac rehabilitation programmes and patients’ own commitment to their recovery and a healthy lifestyle,” said lead author Matthew D. Solomon.

Those who followed all of the recommendations had significantly greater long-term survival, and survival increased with each additional guideline followed. Adherence to one additional guideline recommendation was associated with 8 per cent to 11 per cent lower risk of death, while patients who met all guideline recommendations had 39 per cent to 43 per cent lower mortality compared with those who followed the fewest recommendations.

The study included 25,000 patients who had heart attacks between 2008 and 2014. Patients were followed using data from the electronic health record for a median of about 3 years and up to a maximum of 7 years.
“The high percentage of people achieving all or nearly all of the recommended guidelines highlights the benefits of our integrated health care delivery system’s ability to ensure high-quality follow-up care in recovery after a heart attack,” said senior author Alan S. Go.

Solomon further mentioned that “People often think they are ‘fixed’ after they are treated for a heart attack. But our findings show that following all the recommended treatments after a heart attack is critical to long-term health and wellness. Doctors and patients must work to ensure every single evidence-based recommendation is followed. Following ‘most’ of the recommended treatments is not enough.”

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