Use of medication for cholesterol is low in Brazilians – 07/17/2023 – Health

Almost no Brazilian who suffered a heart attack or stroke (CVA) and is monitored by the Family Health Strategy (ESF) properly uses medication to control cholesterol. Without the use of these drugs, the risk of having complications again is high.

The conclusion is from a Brazilian study published in the journal Lancet Regional Health Americas. The research, financed by the pharmaceutical company Novartis, began with data from more than 2 million individuals assisted by the ESF, a program headed by the Ministry of Health. In the initiative, community health agents make home visits to patients.

Of this total, around 35,000 of them have already had a heart attack or stroke – this was the main public of the study. When someone goes through one of these two problems, the use of medications that regulate blood cholesterol is one of the main ways to avoid recurrence. Among the drug options, the class of statins are recommended.

“Despite all the advances […]statins continue and will continue for a long time as a basic therapy”, summarizes Raul Santos, cardiologist, researcher at Einstein’s Academic Research Organization and one of the authors of the study.

The doctor claims that this type of drug can reduce cholesterol by up to 50% in those who take it. In addition, this type of medicine is safe and has a more affordable cost.

To find out how much stamina was being used in patients with a history of complications, the survey used the question asked by health agents about whether the patient was using any medication. Then, the rate of people with a history of heart problems who were or were not using a statin was observed.

And those numbers were very low. Only 6.7% of them reported the use of medication. In addition to these, it was stratified that only 0.6% used drugs in high doses, considered ideal for further reducing the chance of recurrence of stroke or heart attack.

Another way to control cholesterol more is to use the statin with other drugs, such as the ezetimibe pill. Another way out is the PCSK9 protein inhibitors, which also reduce cholesterol in users.

“It was seen that, if we add ezetimibe or PCSK9 inhibitors, we gain 7% to 20% more in the reduction of cardiovascular events, that is, we manage to potentiate the effects of statins with these combination therapies”, he explains Saints.

The more than 35,000 patients who made up the research, however, did not adopt this model either: only 0.4% reported the use of ezetimibe associated with statins, and the use of PCSK9 inhibitors was basically nil.

Some factors may explain the low adherence to these complementary therapies. For example, the difficulty of access is greater: inhibitors are not available in the public health network, while ezetimibe is even found, but in reduced volumes.

Although the data are a warning, the doctor points out that the information only concerns those people served by the Family Health Strategy. In addition, the research is based on patient reports, which can sometimes be inconsistent. In some cases, for example, someone may say that they are not taking it, but in reality they are routinely using the drugs.

other problems

In addition to care with cholesterol control drugs, the survey noted other difficulties in health care for Brazilians. For example, there was low engagement in the use of aspirin, also recommended for those who had a heart attack or stroke.

Among hypertensive patients, who accounted for almost 80% of the sample, there was also little adherence to high blood pressure treatment. “Patients told us that they were not using the drugs they should theoretically use to prevent new heart attacks and strokes”, says Santos.

In addition to not lowering cholesterol through medication, there are other risk factors for a heart attack or stroke. Sedentarism and smoking are some of these. The authors also observed these lifestyle habits and saw a relationship between them and low medication use.

“Sedentary people and those who smoked more were more likely not to be taking their medication. We understood that there is an association between bad habits […] and not taking the medicine”, concludes Santos.