Roundup: 1 in 4 Medicare Patients are Not Using Their Blood Pressure Meds Properly; Moderate Alcohol Use Linked to Irregular Heartbeat

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September 16, 2016


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Nearly 5 million Americans aged 65 and older, who are Medicare prescription-drug enrollees, are not taking their blood pressure medication as directed, possibly increasing their risk of heart attack and stroke, according to a new study from the U.S. Centers for Disease Control and Prevention (CDC).

The study involved a review of 18.5 million individuals who were Medicare Part D enrollees in 2014. Researchers found that 26 percent either skipped doses of their blood pressure medication or stopped taking the drugs entirely.

High blood pressure can lead to heart disease, stroke, kidney disease, and death. About 70 percent of U.S. adults age 65 or older have high blood pressure, and only about half have their hypertension under control (less than 140/90 mmHg), the CDC says.

“That’s particularly troubling, because other research indicates that up to 25 percent of new prescriptions for blood pressure medicine are never even filled in the first place,” CDC Director Dr. Tom Frieden said. “Of those prescribed those regimens, maybe a quarter don’t even start them, and now we’re finding that another quarter don’t continue them.”

Taking medicine as prescribed, in combination with a healthy diet and regular exercise, improves blood pressure and could ultimately improve heart health, the CDC emphasizes.

The CDC found that adherence to blood pressure medication varies by race and ethnicity. Over one-third of Medicare Part D enrollees that were African American, Hispanic or American Indian/Alaska natives were not taking their blood pressure medicine as directed. This puts them at higher risk of heart attack, stroke, kidney disease and death.

There are also geographic differences. The southern U.S. states, Puerto Rico and the U.S. Virgin Islands have the highest overall rates of people who don’t take their medicine as directed, while North Dakota, Wisconsin and Minnesota have the lowest rates nationwide.

Heart disease and stroke kill 800,000 people every year in the United States, accounting for about one out of every three deaths, according to the CDC.

“A simple action can avoid potentially deadly consequences: take your blood pressure medicine as prescribed,” says the CDC director.

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Moderate Alcohol Use Linked to Irregular Heartbeat

A new observational study is questioning the commonly held notion that just a glass of wine a day could be heart healthy. The new research found that middle-aged and older adults who drink even a little less than one drink per day, on average, are at risk of increasing the size of their hearts’ left atrium.

The left atrium is one of the two upper chambers of the heart, along with the right atrium. When the left atrium is enlarged, a person is at risk for developing a type of irregular heartbeat called atrial fibrillation, or AFib. Being diagnosed with AFib puts a person at risk for other problems, such as stroke. AFib causes blood to pool and clot in the left atrium. If a clot breaks, it can block a blood vessel in the brain, causing a stroke.

Researchers examined data on 5,220 participants from the Framingham Heart Study, the ongoing decades-old study of cardiovascular health in the town of Framingham, Mass. Framingham has provided numerous medical insights over generations related to heart failure, peripheral arterial disease, stroke and arrhythmia.

The analysis of the data showed that about 24 percent, and up to 75 percent, of the relationship between regular alcohol consumption and atrial fibrillation risk could be traced back to enlargement of the left atria.The study did not prove a cause-and-effect link. But it appears that regular drinking increases a person’s risk for atrial fibrillation, the findings showed.

Every 10 grams of alcohol consumed per day — about one drink a day — increased the risk of developing atrial fibrillation by about 5 percent, the study found.

“Our study provides the first human evidence of why daily, long-term alcohol consumption may lead to the development of this very common heart rhythm disturbance,” said Gregory Marcus, M.D., senior study author and associate professor of medicine specializing in cardiac electrophysiology at the University of California at San Francisco. “We were somewhat surprised that a relatively small amount of alcohol was associated with a larger left atrium and subsequent atrial fibrillation.”

The American Heart Association cautions people to consult their doctor on the risks of consuming alcohol in moderation.

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