Lifestyle habits may slip after preventive medication initiation
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Some patients who initiated statin or antihypertensive medications made unfavorable lifestyle changes such as gaining weight and participating in less physical activity, according to a study published in the Journal of the American Heart Association.
Researchers also found that some patients who started such medications made favorable lifestyle changes such as quitting smoking and reducing alcohol consumption.
“Our findings provide support for the hypothesis that people may replace healthy lifestyle change by medication use, as those who started use of preventive medication gained more weight and reduced physical activity compared with those who did not start or need these medications,” Maarit J. Korhonen, PhD, senior researcher at the University of Turku in Finland, told Healio. “While the starters reduced alcohol consumption more and were more likely to quit smoking than those who did not start medications, 70% of the smokers continued smoking after medication initiation and almost 60% with high alcohol consumption continued heavy drinking after medication initiation.”
Researchers analyzed data from 81,772 observations from 41,225 participants (mean age, 52 years; 84% women) from the Finnish Public Sector study aged 40 years and older who were free from CVD at baseline. Questionnaires were completed at baseline and in 4-year intervals to collect information on weight, height, average weekly alcohol consumption, physical activity and smoking status.
Pharmacy claim records were also reviewed regarding information on medication use. Participants were then categorized as the following:
- Initiators, defined as those who filled one or more prescriptions for preventive medications for the first time after baseline and before the second response date,
- Non-initiators, or participants who did not fill prescriptions by the second response date, and
- Prevalent users, defined as those who filled one or more prescriptions for preventive medications at or before baseline.
Of the observations assessed in the study, 10.8% were related to initiators, 32.9% to prevalent users and 56.3% to noninitiators.
Compared with noninitiators, participants who initiated preventive medication had an increase in BMI (difference = 0.19; 95% CI, 0.16-0.22) and a decrease in physical activity (difference = –0.09 metabolic equivalent of task hour per day; 95% CI, –0.16 to –0.02). Participants who were initiators also had a higher likelihood of being physically inactive (OR = 1.08; 95% CI, 1.01-1.17) and having obesity (OR = 1.82; 95% CI, 1.63-2.03).
In contrast, participants who initiated medications were more likely to quit smoking (OR at second survey = 0.74; 95% CI, 0.64-0.85) and had declines in average alcohol consumption (–1.85 grams per week; 95% CI, –3.67 to –0.14) compared with noninitiators.
“Longitudinal studies in other countries/settings with more diverse populations are needed,” Korhonen said in an interview. “As clinical practice guidelines now recommend, new approaches are needed when choosing an optimal strategy for each patient to support the lifestyle change. More research on these interventions is needed.” – by Darlene Dobkowski
For more information:
Maarit J. Korhonen, PhD, can be reached at maarit.korhonen@utu.fi.
Disclosures: Korhonen reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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