A cheap drug combination cuts heart attacks and strokes

Patients at risk of a heart attack or stroke can reduce that risk by taking a combination of three heart drugs: a statin (a cholesterol-lowering drug), a blood pressure drug and low-dose aspirin.

According to a group of American researchers, a recent study has found a simple, cheap way to help patients with diabetes or heart disease avoid heart attacks and strokes. The study was published online in the American Journal of Managed Care.

"This programme has shown that it can be applied in many places to reduce heart attacks and strokes, while also lowering the cost of caring for those events," said Dr James Dudl, diabetes director at Kaiser Permanente. He noted that heart disease is the number one killer in the US and that 23 million Americans have diabetes.

To assess the effect of the combination, the researchers followed 68,560 patients aged 55 and over with heart disease or diabetes. Participants received 40 mg a day of the cholesterol-lowering drug lovastatin and 20 mg of the blood pressure drug lisinopril for two years, and about 75% also took low-dose aspirin.

Participants were divided into three groups: those who took the drugs at least half the time, those who took them less than half the time, and those who took only one of the drugs or none at all. Use was tracked through the number of prescriptions filled. The researchers couldn't measure the use of low-dose aspirin, because it is bought without a prescription.

"We've known for a long time from clinical trials that aspirin, statins and drugs like lisinopril lower the risk of heart attack and stroke in patients with heart disease or diabetes," said a co-author of the study, director of the Center for Evaluation and Innovation at Kaiser Permanente. "Our main goal was to increase the use of these drugs."

Besides its impressive results, the combination caused no obvious side effects. Because the drugs are easy to get and cheap, the combination looks promising for patients at risk.

According to the American Heart Association, adults with diabetes are two to four times more likely to have heart disease and stroke than people without diabetes, and earlier studies have shown that controlling blood sugar does little on its own to prevent them.