Last updated: May 06, 2008

One-quarter of heart patients stop taking their meds before their prescriptions run out. Many of them are now dead.

The American Heart Association recently announced the biggest threat to heart patients—and it's not cheese fries or stress. It is "patients' failure to take prescription medicines correctly."

Statistics suggest that if a doctor prescribes a drug to 100 patients, 12% of them won't fill the prescription, another 12% will fill it but not take a single pill, and 22% will stop taking the drug before the prescription runs out.

Skipped meds, needless heart attacks

When it comes to medications for the heart, skipping doses can be costly. It's estimated that thousands of Americans have avoidable heart attacks each year because they neglect to consistently take the cholesterol-lowering statins prescribed by their doctors. A 2007 study of heart patients suggested that skimping on prescribed medications can double the risk of heart attack, stroke, or other cardiovascular events.

Chris Spelius, 56, of Sun Valley, Utah, is one of those whose stubbornness could have turned him into a statistic. Although his cholesterol was soaring into the 400 range, the former Olympic kayaker was convinced that a vegetarian diet and an active lifestyle would bring it into a safe range. "I've never taken drugs, legal or illegal, and I didn't want to start now," he says.

Finally, his doctor, Eliot Brinton, MD, a preventive cardiologist at the University of Utah School of Medicine, talked him into it. "My job is to badger the patient on a continual basis," he says. "You can have the world's most fit athlete, and they can have high cholesterol, and you can have a couch potato who has low cholesterol." Spelius was obviously in the former category.

Why heart patients skip doses

People have many reasons for skipping doses: forgetfulness, wariness of side effects, and the high cost of some medications, to name a few.

People who are depressed——and that includes up to 20% of heart disease patients——may take a "so what" attitude that makes it hard to stick to a treatment plan.

Heart medications can be especially easy to ignore or forget because most do their work silently. Since you can't feel your cholesterol dropping, you may not notice any obvious benefits of your medication. When Spelius finally went on the statin Lipitor, his cholesterol dropped to 178. On Crestor, another statin, it dipped to a healthy 143.

Here are some strategies for remembering to take your drugs.

  • Make your medicine schedule as simple as possible. Plan times to take your medicines when you are doing other things, like eating or getting ready for bed.
  • Talk with your doctor if you are having problems with your medicine schedule. Your doctor may be able to change your medicines or the times you are taking them.
  • Talk with your doctor if you have any changes in your health that might affect your heart condition, such as side effects of medicines or a medical condition.
  • Use any tools, like daily or weekly pill containers, that make taking your medicines simpler.

"I can't feel my medications working," says Shannon Schroeder, 37, who lives near Seattle. She takes beta-blockers to treat an arrhythmia and a blood thinner to prevent stroke, and occasionally wonders what they are doing to her.

A mini-stroke two years ago gave her a new appreciation of the stakes: "I know that my medications are here to save my life. They give the sense that I'm doing what I need to do to get better."