Side effects also can cause patients to stop taking a heart medicine, according to Sundlof. For example, beta blockers have been found to prolong life in many trials but can also cause impotence, she said. Another troublesome side effect for some patients is a nagging cough some patients develop from ACE inhibitors, which dilate blood vessels. Sundlof said some of her patients are unable to sleep through the night because of the side effect. Patients who take many medicines pose another challenge.
Some patients feel they are on too many medicines.
They might be taking aspirin, beta blockers, ACE inhibitors, two diuretics and medicine for diabetes. That is a problem, Sundlof said. The easier you can make it for your patient, the more likely they will be compliant. Some physician practices and managed care companies try to help educate doctors and patients about the benefits of taking the right heart medicines and getting regular checkups to try to close the gap in compliance. Officials have used report cards the past three years to tell doctors how well they compare with national recommendations for prescribing drugs and conducting checkups.