Placebo just as good as prescription drugs for preventing heart disease if taken regularly

The study revealed adherence to medications is one of the most important predictors of clinical outcomes for patients with diseases like heart failure. This suggests that adherence itself is a marker for other unmeasured variables that can determine outcome.

The consensus is there must be something differentiating people who adhere from people who don’t. Even without understanding the reasons for this outcome, it is believed that improving adherence to medications or supplements should help patients avoid hospitalization and improve survival.

• In findings that can not totally be explained but are sure to lead to future research, Duke Clinical Research Institute investigators have found that adherence to medical therapy, even if the medication is an inert placebo, relates to better outcomes for heart failure patients.
• This finding persisted even after the researchers statistically controlled for a wide variety of patient and treatment characteristics.
• The researchers also said that their findings do not appear to be a statistical quirk because of the large numbers of patients involved and the length of follow-up in the clinical trial that served as the basis for their analysis.
• In an international clinical trial of 7,599 heart failure patients, the researchers found that good adherence was associated with similar lower mortality rates for both the placebo and an angiotensin receptor blocker (ARB), a medication used to relax and dilate blood vessels, when compared to patients who were not as adherent.
• "Our finding that adherence to a placebo was an important and independent predictor of better outcomes suggests that adherence itself is a marker for other unmeasured variables that can determine outcome," Granger continued.
• The typical heart failure patient takes an average of six different medications to control their symptoms and improve their quality of life, the researchers said.
• According to Granger, about two-thirds of all hospital admissions for heart failure are preventable and due to non-compliance in such areas as diet, close attention to symptoms and adherence to drug regimens.
• Since it has been known that poor adherence can limit the effectiveness of medications for heart failure patients, the researchers studied the issue in a large double-blind, randomized controlled clinical trial of the ARB candesartan.
• Even without an understanding of the reasons for this phenomenon, Granger does believe that improving adherence should help patients avoid frequent hospitalization and improve survival.