Did you take your heart medication today? If you answered no, you could be doubling your risk of heart attack, stroke -- or even death.
Still, about 8 percent of heart patients say they skip their medications more than 25 percent of the time, according to a study published this week in the journal Archives of Internal Medicine. And these patients do much worse.
"I think we know that medication nonadherence is an issue," says Dr. Anil Gehi, a fellow in cardiovascular electrophysiology at Emory University School of Medicine in Atlanta and lead author of the study. "This study helps to clarify the overall importance of it."
The study, which looked at more than 1,000 patients, asked one main question: "How often did you take your medications as the doctor prescribed?" Patients who took their medications less than 75 percent of the time were considered noncompliant.
Researchers studied the patients over three years, and they found that patients who did not take their medications were more than twice as likely to suffer a heart attack, stroke, or death during this time.
According to the study, not taking medications is just as bad as smoking or diabetes when it comes to cardiovascular problems down the road.
And noncompliance could be an even more widespread habit than the recent study indicates.
"Because patients who volunteer for studies are likely to be more health conscious than the population in general, the actual proportion of patients with nonadherence is much larger," says co-author Dr. Mary Whooley, associate professor of medicine at the Veterans Affairs Medical Center and University of California at San Francisco.
"Physicians get reports on the refill rates of patients from pharmacy benefits managers, and it is evident that the rates are much higher than 8 percent," says Dr. Seth D. Bilazarian, a cardiologist at Pentucket Medical Associates in Haverhill, Mass.
"It's a big problem, especially in demographic groups with less education; the [noncompliance] rates are much higher … probably 20 to 30 percent."
Dr. Melvyn Rubenfire, director of preventive cardiology at the University of Michigan, says that there are any number of reasons that heart patients may choose not to take their medications. But the biggest issue is cost.
"[Noncompliance] is more common among the elderly, those with financial issues, less well educated, and men who are widowers," he says. Others may choose to skip their medications because they are concerned about toxicity or side effects.
Some patients may also not understand that skipping their meds can have such a profound effect on their health.
"Preventive strategies don't make people feel better, and they don't feel immediately worse by omitting them," Bilazarian says.
So why is this happening? Bernard Gersh, professor of medicine at Mayo Medical School in Rochester, Minn., said that one part of the problem may lie in a breakdown in communication between doctor and patient.
An "understanding of why drugs are being prescribed, [the] relationship with health care providers, [and] time spent with the patient" can help remedy the problem, Gersh said.