Healthy Habits Can Slide After Starting Heart Medications
Some people let healthy habits fall by the wayside after they start medications for high cholesterol or high blood pressure, a new study finds.
Of more than 41,000 middle-aged Finnish adults researchers followed, those who started on cholesterol or blood pressure drugs were more likely to stop exercising or gain weight in the years afterward.
The pattern does not prove that medications, per se, make people lax about lifestyle, said lead researcher Maarit Korhonen, an adjunct professor at the University of Turku in Finland.
But, she said, the findings do suggest that doctors should do a better job of emphasizing the importance of healthy habits.
Dr. Nieca Goldberg, a cardiologist and volunteer expert for the American Heart Association, agreed.
"This is eye-opening for us as clinicians," said Goldberg, who directs the Center for Women's Health at NYU Langone Health in New York City.
"Medications are effective," she noted, "but they don't eliminate the need for a healthy diet and exercise."
For one, Goldberg said, healthy habits can help people keep their medication doses lower, which may limit any side effects.
Even more important, she said, eating nutritious foods and getting regular exercise improves overall health in numerous ways -- from weight control, to boosting fitness levels and strength, to lowering blood pressure and blood sugar.
That message, however, may not be getting through, based on the new findings.
The study, published online Feb. 5 in the Journal of the American Heart Association, involved 41,225 Finnish adults aged 40 and older.
Over 13 years, the study participants were surveyed at least twice about their lifestyle habits and weight. Korhonen's team also used electronic records to track any new medication prescriptions.
On average, people who started taking cholesterol drugs (statins) or blood pressure medication gained more weight by the time they were surveyed again, compared to those who stayed off those drugs. Their odds of becoming obese were 82% higher, the researchers said.
Similarly, medication users reported a dip in their daily activity levels, while nonusers held steady; they were also 8% more likely to become sedentary.
The results do not prove that starting medication makes people complacent about lifestyle, according to Korhonen.
But it wasn't simply that people on medication were older, she noted. Among people in their 40s, for example, those on heart medications typically gained more weight and became less active.
There was some good news, however: People who started on medication were 26% more likely to quit smoking and, on average, they curbed their usual alcohol intake.
Those findings are encouraging, Goldberg said, particularly since smoking is a major risk factor for heart disease and a difficult habit to break.
The study was done in Finland, and it's not clear whether the findings would translate to other countries, the authors noted. But some recent research in the United States and Korea has found a similar pattern -- with statin users showing bigger increases in calorie and fat intake, obesity and inactivity compared to nonusers.
Korhonen said the take-away is straightforward: "People who start blood pressure or cholesterol medications should continue to manage weight, be physically active, manage their alcohol consumption and quit smoking."
The American Heart Association has advice on a heart-healthy lifestyle.
SOURCES: Maarit Korhonen, Ph.D., M.Sc., adjunct professor of clinical chemistry, University of Turku, Turku, Finland; Nieca Goldberg, M.D., director, Center for Women's Health, NYU Langone Health, New York City, and volunteer expert, American Heart Association; Feb. 5, 2020, Journal of the American Heart Association, online