Side effects major hurdle for heart drugs

Even relatively mild side effects can be enough to keep older patients from taking drugs designed to prevent heart attacks, according to a new study from the Yale School of Medicine. 

The study, which will be published in the Archives of Internal Medicine and is already available on the journal's website, involved in-person interviews with 356 people over the age of 65. "Large proportions (48 to 69 per cent of the participants) were unwilling or uncertain about taking such medication if it caused mild fatigue, nausea, or fuzzy thinking," the researchers reported. 

Specifically, 48 per cent of the participants said they would not take or were not sure about taking a medication associated with fatigue and dizziness even if the side effects were mild enough not to interfere with the activities of daily living. 

"These patients are willing to take medications for cardiovascular disease prevention, but only if they are not linked to what are generally considered to be acceptable side effects," said first author Terri R Fried, professor of internal medicine/geriatrics at Yale.

However, 88 per cent of the participants said they would take a medication that had no adverse effects and offered about the average risk reduction of currently available medications.

"Guidelines need to recognise that adverse effects of medications, even when mild, are not 'side effects' but rather competing outcomes important in their own right," the researchers concluded. "The decision about whether to take a medication should not be predicated on magnitude of benefit alone but rather on the balance of benefits and harms."