Medications: Myths Versus Facts

Taking medication can be an important part of managing heart-health issues like cholesterol or blood pressure or reducing your risk of stroke — and the benefits of preventive medication greatly outweigh the risks, according to Gregg C. Fonarow, M.D., Professor of Medicine and Director of the Ahmanson-UCLA Cardiomyopathy Center.

“Cardiovascular disease often develops silently, so there won’t be any symptoms warning you that a heart attack is going to happen in the near future,” said Dr. Fonarow, who is also an American Heart Association volunteer.

Here are some of the top myths about taking cardiovascular medication:

1. I feel OK, so I don’t need to take my medication. Just because you’re feeling OK one day doesn’t mean you can stop taking your medications, especially those that could reduce your risks for heart disease, Dr. Fonarow said. “Patients feel the same whether they take their preventive medication or not until they have a cardiovascular event, which could have been prevented if they’d taken their medication as prescribed,” he said.

   Taking your medication as prescribed can play an important role in its effectiveness, said Gerald Fletcher, M.D., professor of medicine and cardiovascular disease at the Mayo Clinic College of Medicine in Jacksonville, Fla. Many medications take time to reach optimal effectiveness, so sticking to a consistent regimen is important.

   When treating high cholesterol, for example, medication may help blood lipids to drop, but that beneficial effect may be lost if you stop taking it, he said.

   Patients with high blood pressure can make lifestyle changes such as adopting a healthier diet pattern, getting more physical activity and maintaining a healthy weight to reduce or even eliminate some medications. But that should be done with the supervision of your health provider, Dr. Fletcher said.

2. I don’t need to tell my doctor about the vitamins and supplements I take. Even though they don’t require a prescription, vitamins and supplements can take a toll on your body’s chemistry and alter the effectiveness of some medications

   One example is the role vitamin K plays in how the body reacts to a *blood thinner such as warfarin, which is commonly known under the brand Coumadin. Increasing your vitamin K levels without consulting your health care provider to also adjust your dose of blood thinners could cause the blood to thicken, raising the risk of clotting.

   Other supplements, such as fish oil, can help lower your triglycerides. They need to be accounted for when monitoring the effectiveness of other medications with the same goal, Dr. Fletcher said.

   “Fish oils are good, but they should never replace the statins.” Dr. Fletcher said.

3. Natural supplements are better than pharmaceuticals. While many patients feel natural supplements or vitamins offer a natural way to lower their cardiovascular risk, research hasn’t been able to prove it, Dr. Fonarow said.

   “Study after study as failed to show effectiveness of any vitamins on lowering cardiovascular risk,” he said.

   And because natural supplements and vitamins don’t undergo the same scrutiny of prescription medication, there can be some uncertainty over integrity of ingredients, Dr. Fletcher said.

   “Many of these supplements are manufactured in one place and packaged somewhere else in the world, so you don’t always know exactly what’s in them,” he said. “That can be a big problem because a supplement may interact with the drugs you are already taking.”

4. Only brand-name medications work. For many years, newer, branded medications were more potent and more effective than those available as generics, but that’s no longer the case, Dr. Fonarow said.

   “It’s now possible to lower cardiovascular risk very inexpensively using generics,” he said. “Medications that were hundreds of dollars per month are now $4 a month.”

   Dr. Fonarow encourages patients to talk to their doctors about medications available, adding that in some rare cases a branded drug could be better tolerated than a generic, but that’s usually not true for high blood pressure and cholesterol drugs.

5. It’s fine to take over-the-counter medications if I have a headache or congestion. Have a cold? Talk to your doctor or pharmacist before taking an over-the-counter cold medication. Many include stimulants that can have an adverse reaction with blood pressure medication, Dr. Fletcher said.

   “You may just be thinking of clearing a stuffy nose, but if it has a stimulant such as epinephrine or ephedrine, those can make your heart rate go up and that can be dangerous if you’re under treatment for high blood pressure,” Dr. Fletcher said.

   And certain pain relievers, such as non-steroidal anti-inflammatory drugs, may interfere with medication designed to treat hypertension, Dr. Fonarow said.

   “It’s very important, on every visit, to let your physician know what over-the-counter drugs you are using,” he said.

6. Taking pills are the only answer. Taking medication as recommended is important, but working to avoid medication through lifestyle choices can be even more effective, Dr. Fletcher said.

   “Many people think, ‘I’m too busy to exercise, so I’d rather just take a pill,’ but it’s much better to have a healthy lifestyle,” he said. “It’s possible to reduce or eliminate medication if you focus on a healthy diet, good exercise and good sleep.”