Last updated: May 15, 2008
heart-disease-one-aspirin
Skipping this pill can triple your risk of death within a year.
(TOM GRILL/CORBIS/HEALTH)
Whether you're trying to recover from a massive heart attack or hoping to mitigate your risk factors, the right prescription heart drug can put your goals within reach. In recent years doctors have hit upon effective combinations for the most common heart conditions. The future of heart attack and heart disease patients depends in part on the contents of their medicine cabinet, says Sharonne Hayes, MD, director of the Mayo Clinic's Women's Heart Clinic. "Heart patients who go home with aspirin, a statin, and a beta-blocker have fewer second heart attacks and live longer than those who don't," she says.


When lifestyle changes aren't enough
John Maiorana, a 65-year-old retired Navy chaplain living in Virginia Beach, Va., has been taking Lipitor every day since his quadruple bypass surgery 10 years ago. His doctor runs a simple blood test every year to check for signs of liver damage—a standard procedure for anyone taking a statin—but the drug has never caused Maiorana any trouble.

Over the years the combination of Lipitor, regular exercise, and a low-fat diet has brought his total cholesterol down from the high 240s to the low 150s and allowed him to enjoy his retirement. "I walk, I jog, and I even eat pizza with cheese on it," he says. "I just don't overdo it."


Using medication to avoid surgery
If you have heart disease but have never suffered a heart attack or gone through bypass surgery, the right medications can help keep you out of the hospital. In fact, improvements in drug treatments may in part explain why bypass surgeries have sharply declined in the past decade. As more people manage to control their symptoms and slow their disease with drugs, fewer need to go under the knife.

Statins can clear artery-clogging cholesterol, beta-blockers can lower blood pressure while preventing runaway heartbeats, and warfarin or aspirin can help to prevent dangerous blood clots. If taken properly by at-risk patients, these drugs have the potential to save many of the hundreds of thousands of lives lost to heart disease in the U.S. each year.

Consequences of skipping doses
But a prescription is just a piece of paper. You need to follow through by taking the drugs as directed. A new four-year study of patients with coronary artery disease found that patients who skimped on their prescribed medications were more than twice as likely to suffer a heart attack, a stroke, or fatal heart trouble. By some estimates, failing to take either aspirin, a beta-blocker, or a statin after a heart attack nearly triples the risk of dying within a year. Watch a video of a young heart attack survivor who admits he often skipped his cholesterol medication, and hear what he tells his younger brother about taking it.

Taking medications correctly is ultimately a one-person job, but that doesn't mean you can't have a little help. Talk to your doctor and pharmacist to make sure you understand your medications—what they can do, how to take them, and how to keep side effects to a minimum.

If cost is an issue, ask your doctor if generic drugs are an option. (Significantly cheaper generic versions of several brand-name heart medications—including two statins—have become available in recent years.) And remember, even if medications are expensive, the cost of not taking them can be incalculably higher.