Too many drug types are compromising heart health: doctors

Some cardiologists think prescribing has gotten out of hand.

The criticism was voiced by a number of leading heart doctors who attended the annual scientific sessions of the American College of Cardiology, held on March 9-11 in San Francisco. They said eliminating certain drugs could potentially improve care without compromising treatment. Evidence is growing that some medications are not effective.

Patients who need multiple daily doses of a given drug often fail to take them, said Dr. Steven Nissen, head of cardiology at the Cleveland Clinic and a past president of the ACC. "There is also the question about whether the benefits are additive."

Among the medications cardiologists are giving a second look: AbbVie's Niaspan, or prescription niacin, which aims to raise good cholesterol; so-called fenofibrate such as top-selling branded drug TriCor (also from AbbVie), which lowers blood fats called triglycerides; and beta-blockers, most of which are inexpensive, older generics.

'EAGER TO ADD, RELUCTANT TO TAKE AWAY'

A person who has had a heart attack typically leaves the hospital on a beta-blocker to slow the heart, an ACE inhibitor to reduce blood pressure, clopidogrel and aspirin to thin the blood and prevent clots, and a statin to reduce cholesterol, said Dr. Micah Eimer, a cardiologist with Northwestern Medicine in suburban Chicago.

"That's a minimum of five medications, and each one has a proven mortality benefit. It's practically malpractice if you don't prescribe those," Eimer said. "But we have

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