If you have or a family member has been diagnosed with a cardiovascular disease (CVD), the doctor would have provided a comprehensive treatment plan to help manage the disease. This may involve a combination of lifestyle changes and prescription medications. Prescription medications are an essential part of the journey towards effective CVD management — they help control your symptoms, prevent further complications, and treat your heart condition. But despite knowing the importance of medications, many people find it challenging to adhere to their prescriptions plans. This could be because of busy schedules, fear of side-effects, or simply forgetting to do so. Non-adherence to CVD medications can have detrimental impacts on your or your family member’s disease outcomes, and can also increase the risk of adverse cardiovascular events. In this article, we break down the types of heart medications that may be prescribed, the harmful effects of not adhering to prescription plans, and simple tips you can follow to ensure you take or your family member takes their medications regularly.

Understanding heart disease medications

Depending on the type or severity of the CVD you or your family member may have, the doctor will choose medications that are most likely to be safe and effective for disease management. The doctor may even prescribe medications to help keep CVD risk factors — such as high blood pressure and high blood cholesterol — in check. Medicines for CVDs belong to a few main groups, some of which are listed below:

• Antiplatelet medicines: These are prescribed to patients who experienced heart attacks or angina (episodes of chest pains due to narrowing of the arteries supplying the heart). These medicines reduce the risk of another heart attack by preventing platelets from forming blood clots and blocking the arteries.
• Cholesterol-lowering medicines: These medicines, such as statins, lower the production of cholesterol in the liver. This in turn reduces the risk of ‘bad’ cholesterol clogging the arteries. Doctors may prescribe cholesterol-lowering medicines to patients who experienced heart attacks or strokes, or even to those who are vulnerable to serious CVDs.
• Antiarrhythmic medicines: These medicines help in normalizing the heart rhythm in patients with arrythmias like atrial fibrillation. Some examples are beta-blockers, calcium channel blockers, and digoxin.
• Angiotensin-converting enzyme (ACE) inhibitors: The function of the ACE is to narrow your blood vessels. Thus, these medications limit this enzyme, enabling your blood vessels to relax and allowing blood to flow easily. ACE inhibitors may be prescribed to patients who experienced heart attacks or angina, and to also those with high blood pressure.

This is not a comprehensive list of all the medications for managing heart conditions. The medicines prescribed may also have to be taken in different ways, such as orally, by injection into the vein or under the skin, or by self-adhesive patches. However, there are several more aspects that need to be considered regarding CVD medications. It is important to fully understand the medications that have been prescribed by your doctor, and these points may be helpful when speaking with your doctor about your prescription plan:

• What are the medicines for?
• Why is taking the medicines important for my or my family member’s heart health?
• How to take the medicines safely?
• For how long do the medicines need to be taken?
• What are the possible side-effects of the medicines?
• What should be done if side-effects develop?

Having answers to these questions and engaging in an open discussion with your doctor can greatly ease your worries and give you more confidence in sticking with the prescription plan.

Adverse impacts of medication non-adherence

Adhering to your or your family member’s prescription plan is critical in preventing potentially life-threatening events like heart attacks and strokes. Several research studies have shown that low medication adherence is associated with poor CVD outcomes among patients:

• Prescription plans with blood pressure-reducing medicines can reduce the risk of stroke by approximately 30% and heart attacks by approximately 15%. But research has shown that as many as 50% to 80% of patients treated for high blood pressure do not stick to their treatment regimens.

• According to the World Health Organization, the lack of medication adherence is the most important cause of failure to control blood pressure. Poor blood pressure control significantly increases the risk of heart attacks, strokes, and hospitalizations.

• Adherence to cholesterol-lowering medicines (such as statins) and antiplatelet medicines is also poor. Within 6 months to 1 year after having been prescribed statins, approximately 25% to 50% of patients discontinue them. At the end of 2 years, non-adherence is as high as 75%.

• One study found that patients who had the highest adherence to their cholesterol-lowering medications also had the highest reductions in ‘bad’ cholesterol levels after three years. They also had a 40% lower risk of adverse cardiovascular events.

From the statistics above, it is clear that CVD patients find it challenging to adhere to their medications on a long-term basis. However, for those who successfully adhere to their treatment plans, the benefits are multifold. They are less vulnerable to heart attacks and strokes, at lower risks of developing serious CVDs, and less likely to become hospitalized due to complications. This in turn reduces the financial burden and disease-related stress on the patient and on the family members as well.

Remember, even if you think that your or your family member’s heart condition or symptoms are under control, it is essential to stick to the prescription plan. This is required to avoid the worsening of the heart condition or symptoms. Always talk to your doctor if you have doubts about the frequency of your medications before taking any drastic steps.

Ensuring successful medication adherence

A busy work schedule or having to run several errands in a day can make you easily forget taking your medications. Here are a few tips to help you or your family member successfully stick to the prescription plan:

• Incorporate taking medications into daily activities such as brushing your teeth, having breakfast, or sleeping.
• Set up reminders or alarms on your phone to help you or your family member remember to take the medications.
• Creating a calendar can be incredibly helpful for complex prescription plans.
• Weekly pill boxes will help you organize all the medications in separate compartments and keep track of them as well.
• Involve your family members, friends, or neighbours you trust in reminding you to take your medications.

Key take-home messages

• Effective CVD management is a journey that requires patience and commitment, and long-term medication adherence is an essential part of this journey.
• Prescription plans do not work their magic overnight, they take time to yield positive effects on your or your family member’s symptoms and heart conditions.
• There are simple ways in which you can integrate taking your prescription medications into your daily routine. This will help ensure you or your family member successfully comply with the prescription prescription plan.
• If you are ever concerned about the CVD medications that need to be taken, it is best to voice these concerns to a doctor, a trusted and valuable source of information.
• Remember, successful medication adherence is an important aspect of managing CVDs and their risk factors, so don’t take it easy with your and your family’s heart health!

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