A 42 year old, fit, slim, non smoking patient of mine had a heart attack recently and made a full recovery. He's got normal blood cholesterol levels and blood pressure, but his cardiologist has put him on a statin, ACE inhibitor, beta blocker, and aspirin and told him the regimen is for life. He doesn't want to take the pills and asked me if they're really necessary.
This New Zealand study shows why he should keep taking them. A low risk person like him who has had a heart attack has a similar chance of a further episode as the highest risk individual who has never had cardiovascular disease (CVD). Over the next five years, he is five times more likely to have a CVD event than those without prior CVD.
The authors suggest that if resources are limited we should concentrate our efforts on people like my patient, rather than the general population. And he should keep taking the tablets.
Source: Heart 2009;95:125-129
Dr Ann Robinson, BMJ Group