Medication Use After Heart Attack Varies By Kidney Status

But variations in adherence and use are unlikely to explain differences in long-term outcomes

THURSDAY, July 17 (HealthDay News) -- In older heart attack survivors, the use and adherence to recommended cardiovascular medications varies by kidney status but is unlikely to explain differences in long-term outcomes, according to research published online July 9 in the Clinical Journal of the American Society of Nephrology.

Wolfgang C. Winkelmayer, M.D., of Brigham and Women's Hospital in Boston, and colleagues conducted a retrospective cohort study of older patients who were discharged after a heart attack between 1995 and 2004, including 17,403 with no kidney disease, 3,645 with chronic kidney disease and 436 with end-stage renal disease.

The researchers found no differences between patients with or without chronic kidney disease in cardiovascular medication use and adherence with the exception of the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARBs), which was 22 percent lower in patients with chronic kidney disease. They also found that patients with end-stage renal disease had a 43 percent lower use of ACEI/ARBs, a 17 percent lower use of statins, and a lower adherence to beta blocker regimens.

"Detection of potentially modifiable factors that are specific to advanced kidney disease and the development of candidate therapies and proof of their efficacy to reduce cardiovascular risk in kidney disease should be a top priority for the investment of private and public funds, especially given the high and increasing prevalence of kidney disease," the authors conclude.

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