Featured Research

from universities, journals, and other organizations

Kidney Disease Linked To Lower Medication Use After Heart Attack

Date:
July 9, 2008
Source:
American Society of Nephrology
Summary:
Patients with kidney disease -- especially end-stage renal disease requiring dialysis -- are less likely to receive recommended medications after a heart attack, reports a new study.

Patients with kidney disease--especially end-stage renal disease (ESRD) requiring dialysis--are less likely to receive recommended medications after a heart attack, reports a new study.

Related Articles


"This is the first systematic report to investigate whether kidney function is associated with use of and adherence with medications that are recommended for secondary prevention after a heart attack," comments Dr. Wolfgang C. Winkelmayer of Brigham and Women's Hospital in Boston, MA. "We found that use of several medications after a heart attack was lower in patients with chronic kidney disease (CKD) or ESRD. However, 1-year adherence did not differ by kidney function."

The researchers analyzed data on medication use after a heart attack, or myocardial infarction, in approximately 21,500 patients. Seventeen percent of the patients had CKD--loss of kidney function that, in many cases, progresses to ESRD. Another two percent had ESRD--permanent loss of kidney function requiring dialysis or transplantation.

Patients with and without kidney disease were compared for use of medications recommended after myocardial infarction: beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEIs/ARBs), and cholesterol-lowering "statin" drugs. Along with aspirin, these three types of drugs are an important part of strategies to prevent further events after myocardial infarction.

Overall rates of medication use were low: after leaving the hospital, just 27 percent of patients filled a prescription for a statin drug. Forty-four percent started treatment with ACEIs/ARBs and 57 percent with beta-blockers.

After adjustment for other factors, patients with CKD were 22 percent less likely to start beta-blocker treatment, compared to patients without kidney disease. There was no difference in ACEI/ARB or statin use.

For ESRD patients, rates of medication use were even lower: 43 percent lower for ACEIs/ARBs and 17 percent lower for statins. (Patients with ESRD were also less likely to start beta-blocker treatment, although the difference wasn't significant.)

Among patients who filled a first prescription, rates of continued medication use after one year were 64 percent for beta-blockers, 57 percent for statins, and 54 percent for ACEIs/ARBs. For all three types of drugs, adherence rates were similar for patients with and without CKD. Patients with ESRD were less likely to continue beta-blocker treatment.

The results may help in understanding how medications affect the relationship between kidney disease and cardiovascular disease. "Kidney function is a well-established risk factor for cardiovascular events such as heart attacks and is also associated with a worse prognosis after such events," says Dr. Winkelmayer. "One possible explanation is differences in health service delivery--it may be that patients with more advanced kidney function receive less state-of-the art care after a heart attack, including less acute coronary intervention, less acute medical intervention, and less chronic, secondary prevention." The results also show some important differences in medication use after myocardial infarction by patients with kidney disease, particularly ESRD. However, these differences don't appear to explain the higher cardiovascular risk among patients with low kidney function.

Over time, rates of adherence to all three types of medications for myocardial infarction are surprisingly low--for patients with and without kidney disease. Especially as rates of kidney disease continue to rise, new ways of reducing cardiovascular risk among patients with low kidney function should be a top priority, the researchers conclude.

The study was limited by a lack of data on vital and laboratory measurements. This included tests to confirm the presence of kidney disease, which was ascertained from health care claims.

This work was supported by an American Heart Association Scientist Development Grant (0535232N) and a Norman S. Coplon Extramural Research Program Award from Satellite Research to Dr. Winkelmayer.


Story Source:

The above story is based on materials provided by American Society of Nephrology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Associations of Kidney Function with Cardiovascular Medication use After Myocardial Infarction. Clinical Journal of the American Society of Nephrology, September 2008

Cite This Page:

American Society of Nephrology. "Kidney Disease Linked To Lower Medication Use After Heart Attack." ScienceDaily. ScienceDaily, 9 July 2008. <www.sciencedaily.com/releases/2008/07/080709120534.htm>.
American Society of Nephrology. (2008, July 9). Kidney Disease Linked To Lower Medication Use After Heart Attack. ScienceDaily. Retrieved November 23, 2014 from www.sciencedaily.com/releases/2008/07/080709120534.htm
American Society of Nephrology. "Kidney Disease Linked To Lower Medication Use After Heart Attack." ScienceDaily. www.sciencedaily.com/releases/2008/07/080709120534.htm (accessed November 23, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, November 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

AFP (Nov. 23, 2014) The arable district of Kenema in Sierra Leone -- at the centre of the Ebola outbreak in May -- has been under quarantine for three months as the cocoa harvest comes in. Duration: 01:32 Video provided by AFP
Powered by NewsLook.com
Don't Fall For Flu Shot Myths

Don't Fall For Flu Shot Myths

Newsy (Nov. 23, 2014) Misconceptions abound when it comes to your annual flu shot. Medical experts say most people older than 6 months should get the shot. Video provided by Newsy
Powered by NewsLook.com
WFP: Ebola Risks Heightened Among Women Throughout Africa

WFP: Ebola Risks Heightened Among Women Throughout Africa

AFP (Nov. 21, 2014) Having children has always been a frightening prospect in Sierra Leone, the world's most dangerous place to give birth, but Ebola has presented an alarming new threat for expectant mothers. Duration: 00:37 Video provided by AFP
Powered by NewsLook.com
Could Your Genes Be The Reason You're Single?

Could Your Genes Be The Reason You're Single?

Newsy (Nov. 21, 2014) Researchers in Beijing discovered a gene called 5-HTA1, and carriers are reportedly 20 percent more likely to be single. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins