Does Blood Pressure, Cholesterol Medication Use Affect Healthy Habits?

Maintaining a healthy lifestyle is still necessary even after antihypertensive and cholesterol medications are initiated; however, a recent study found that many abandon beneficial lifestyle changes following pharmacologic treatment.

Although antihypertensive medications and statins are commonly used for the prevention of cardiovascular disease (CVD), lifestyle modification remains a key component of prevention.

The study, published in the Journal of the American Heart Association, examined whether initiation of preventive medication affected lifestyle in patients at risk for heart disease and stroke. According to the findings, patients in the study who took cholesterol- or blood pressure-lowering medications were more likely to gain weight and reduce activity compared with nonusers. 

“Medication shouldn’t be viewed as a free-pass to continue or start an unhealthy lifestyle,” lead study author Maarit J. Korhonen, PhD, senior researcher at the University of Turku, said in a press release. “Our research sought to determine if people who started medications were making the lifestyle changes necessary to see health benefits.”

The study evaluated data from 41,225 participants in Finland aged 40 years and older who did not have CVD at baseline. Participants responded to surveys administered in 4-year intervals from 2000 to 2013. Pharmacy claims data was used to analyze medication use. Overall, there were 8837 treatment initiators and 46,021 non-initiators.

Compared with those who did not start on the medications, those who did were more likely to reduce their physical activity and were 8% more likely to become physically inactive. Twenty-eight percent of those who initiated treatment were more likely to become obese or have an increase in body mass index and 26% were more likely to quit smoking, according to the data.

In addition, smokers who initiated preventive medication were more likely to either quit or decrease smoking compared with untreated smokers, the authors noted. Although average alcohol consumption did decrease more among initiators than non-initiators, there was no difference in the odds of heavy drinking, the study found.

The authors considered that a key limitation of the study is the generalizability of the results, which were limited by the lack of additional details regarding each patient’s diets, blood pressure measurements, and cholesterol levels. Study participants were also white and predominantly female public-sector workers, therefore the results may not accurately extend to diverse populations.  

In conclusion, the authors indicated that the expansion of pharmacologic interventions toward populations at low CVD risk may not necessarily lead to expected benefits at the population levels.

“Effectives measures are needed to support the recommended lifestyle changes in relation to the initiation of pharmacologic interventions for primary prevention,” the authors wrote.

References:

1. Korhonen MJ, Pentti J, Hartikainen J, et al. Lifestyle changes in relation to initiation of antihypertensive and lipid-lowering medication: A cohort study. Journal of the American Heart Association. 2020. Doi: https://doi.org/10.1161/JAHA.119.014168

2. Healthy habits still vital after starting blood pressure, cholesterol medications [news release]. https://newsroom.heart.org/news/healthy-habits-still-vital-after-starting-blood-pressure-cholesterol-medications?preview=82f8. Accessed February 5, 2020.