Fear of developing side effects — even mild ones — would stop many older patients from taking medications that provide only average benefit in preventing heart attack, a recent study found.

Of 356 community-dwelling persons aged 65 years and older, 88% said they would be willing to take an agent that provided an absolute benefit of six fewer persons with MI out of 100—if the drug had no adverse effects. But once mild fatigue, nausea, or fuzzy thinking were introduced as possible consequences, 48% to 69% of the respondents reported being unwilling to or uncertain about taking such a drug. Only 3% would take medication with adverse effects severe enough to affect daily functioning.

“Older persons’ willingness to take medication for primary cardiovascular disease prevention is relatively insensitive to benefit but highly sensitive to its adverse effects,” summarized Terri R. Fried, MD, and colleagues, in their online report for Archives of Internal Medicine.

Continue Reading

In other cardiovascular-health developments:

Data indicate that air pollution triggers as many heart attacks as such individual risk factors as physical exertion, exercise, and coffee. MI can also be brought on, to different extents, by anger, positive emotions, sexual activity, cocaine or marijuana use, and respiratory infections (Lancet. 2011;377:732-740).

While obesity is a major determinant of cardiovascular disease, BMI, waist circumference, and waist-to-hip ratio each have a similar impact on the risk of subsequent MI and stroke. This suggests that people with central obesity may not be at any higher risk of these events (published online in Lancet)