UF Researchers: Many Heart Attack Patients Nationwide Are Not Receiving The Best Medications

January 14, 1997

GAINESVILLE—”Out with the old and in with the new” may not be the best New Year’s resolution if you have a heart attack in 1997, caution researchers at the University of Florida and the Gainesville Veterans Affairs Medical Center.

Instead, cardiologists recommend asking your doctor about a cadre of seven medications long proven to prolong life.

Incredibly, they say, more than half the nation’s heart attack patients are discharged from hospitals without prescriptions for many of these tried-and-true formulations, which can prevent death or a subsequent attack.

Not only are these drugs effective — they are much cheaper than newcomers to the market. Ranging from aspirin to antioxidants such as vitamins E, C and A, the medications should be the standard of care until further studies show newer arrivals to the market are superior or comparable, experts say.

The doctors’ advice? Be sure to ask about beta-blockers. Of the seven recommended drugs, they are among the most beneficial.

Researchers at UF and the Gainesville VA Medical Center are zeroing in on whether VA patients with a documented heart attack were prescribed the helpful medication. Beta-blockers reduce the heart’s work load, slowing heart rate. They also reduce the force of contractions. In all, this lowers the likelihood of further damage to the heart muscle.

So far, the news is good — about 90 percent of patients who survived their heart attack were discharged from Gainesville’s VA Medical Center on beta-blocker therapy. All were 50 to 70 years old.

Yet in Florida, only 48 percent of heart attack patients receive beta-blockers, a trend that mirrors nationwide statistics, according to the Quarterly Data Report of the National Registry of Myocardial Infarction.

“Drugs like beta-blockers are inexpensive and are proven to lower the incidence of death in study after study,” says Dr. Jawahar Mehta, a professor of medicine at UF’s College of Medicine and staff cardiologist at the VAMC. “Yet to our great dismay, patients treated for heart attacks at many hospitals nationwide don’t go home on them.”

Mehta said these seven drugs have been found to have protective qualities:

  • Aspirin, which prevents platelets from clumping and causing reduced blood flow to the heart;
  • Heparin or other blood-thinning drugs such as warfarin or coumadin, which prevent blood clotting;
  • Clot-busting drugs such as TPA, used to dissolve clots that have formed in coronary arteries;
  • Beta-blockers, which reduce the work load performed by the heart and help prevent it from injury;
  • ACE inhibitors, which halt formation of the powerful vessel-narrowing enzyme angiotensin and prevent enlargement of the heart;
  • Anti-oxidants, including vitamins such as E, C and A, which break the chain of formation of toxic substances in the body;
  • Cholesterol-lowering medications.

“During the past 20 years, we’ve seen more than a 50 percent decline in death from heart attack, and this reduction may be due to better preventive measures and better therapies,” said UF College of Pharmacy resident Kathleen Findley, who is collaborating with Mehta and Assistant Pharmacy Professor David Frohnapple on the study.