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Daily Placebo Works
Better Than Taking An Active Drug Irregularly
posted November 30, 2004
Regular pill popping decreases heart risks.
When it comes to heart disease, it may not be what pill you take, but how
regularly you take it that is important. The finding controversially implies
that so long as patients stick to a daily regime, they would do just as well
with a placebo.
Bradi Granger of Duke University in Durham, North Carolina, and her colleagues
re-analyzed the results of a clinical trial involving nearly 7,600 heart-failure
patients who were testing an experimental angiotensin receptor blocker (ARB),
which relaxes blood vessels and lowers blood pressure.
Patients who took their pills every day halved their risk of dying by the end of
the study, compared with those who skipped pills, Granger's team found,
regardless of whether they took the drug or a placebo. Those who stuck to their
pills were also less likely to spend time in hospital.
Experts suspect that those who stick to their medicine are also more likely to
stick to other heart-healthy activities such as regular exercise, good diet and
not smoking or drinking. These behaviours alone probably outweigh the
physiological effect of the drug.
If doctors could identify those patients who are unlikely to take their drugs
regularly, Granger believes that they could be targeted with education or social
support that would encourage them to follow a healthier lifestyle.
Two other earlier investigations have also shown that patients with heart
disease get benefits from taking a regular placebo that almost match those
provided by beta-blockers or lipid-lowering drugs. But researchers have
struggled to explain exactly what is different about those who follow their
doctor's instructions compared with those who flout them.
Another, more controversial, implication of the new results is that those people
who are diligent about taking their drugs and following a healthy lifestyle
might reap the same benefit if they cut their dose or switched from active drugs
to a cheaper placebo. "It's definitely worth a study," Granger says.
November 2004 News Article Index
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