Some see blood pressure, cholesterol meds as substitute for healthy habits

Reuters Health: People who start taking medication to lower their blood pressure and cholesterol may think they can drop healthy lifestyle habits, a study in Finland suggests.

Researchers surveyed more than 41,000 people with no history of heart disease and found that those who started hypertension and cholesterol medications were more likely than those who didn’t to cut back on exercise and put on extra weight.

They were also more likely to quit smoking, but that didn’t entirely explain the amount of weight gained in this group, the researchers report in the Journal of the American Heart Association.

“Unfavorable changes in lifestyle may reduce beneficial effects of medication use,” co-author Maarit Korhonen of the University of Turku said by email.

In the early 2000s, US surveys found that people using cholesterol-lowering statin therapy had lower calorie and fat intake than non-users, but more recent studies have suggested the opposite is now true, Korhonen and colleagues note in their report.

That may be because guidelines have expanded the use of statins and blood pressure medications to people at lower risk for heart disease, said Dr. Mary Ann Bauman, a member of the American Heart Association’s national board of directors, who wasn’t involved in the study.

As prescribing of medication to stave off heart disease expands, Korhonen’s team wanted to learn whether patients are more likely to complement their medications with healthy lifestyle changes or more inclined to replace lifestyle efforts with the medicines.

The survey participants were all public sector workers, all over age 40 and mostly women. Each answered a questionnaire at least twice in four-year intervals between 2000 and 2013.

Compared to people who didn’t start medication during this period, those who did were 82% more likely to become obese and 8% more likely to become physically inactive.

“People often think that taking a medication will suffice for controlling for a disease and get a false sense of security that they don’t need to make lifestyle changes and that the pill will take care of the problem,” Bauman said in a phone interview.

It is often easier to take a pill than to make lifestyle changes such as engaging in exercise, eating healthy and maintaining a healthy weight, she added.

The dangers of cigarette smoking are well known and that could be what prompted people to give up the habit, Bauman noted. Intensive public health actions in Finland during the study period, such as prohibition of smoking in workplaces and restaurants, may have also contributed to the high quit rate, the study authors point out.

To get patients to adopt or keep up healthy lifestyle habits, clinicians could try finding out the patient’s reasons for changing their lifestyle and engage in discussions to incorporate those motives and preferences into a regimen they could stick with, Korhonen said.

“Rather than telling someone to just cut out sugar in your diet because of the calories, we might tell them cut to out one soda a day for a month, then maybe try two. Give them goals that can be realised,” Bauman added.

“If we are going to prevent these diseases, we have to be able to motivate people to want to make the changes to have a healthy lifestyle. We also have to make it easier systemically through policy, as we are doing here with smoking,” Bauman said. (SOURCE: bit.ly/2SUVWE4 Journal of the American Heart Association, online 5 February 2020.)