Patients with undiagnosed heart disease who take a statin or beta blocker may have a mild event as their first sign of disease rather than myocardial infarction, according to an article in the February 21 issue of Annals of Internal Medicine.

Investigators with Kaiser Permanente Division of Research, Stanford and University of California San Francisco Medical Center evaluated nearly 1,400 adult men and women in Northern California and found that only 20 percent of those who presented with myocardial infarction were taking a statin compared with 40 percent of patients who presented with exercise-induced angina. The researchers also found that women were less likely than men to have a myocardial infarction as the first symptom of heart disease.

"We know that statins and beta blockers can decrease your risk of heart disease," said Alan Go, MD, lead author of the study. "So if you are at increased risk for having heart disease and your doctor were to treat you with these types of medications, our study suggests that you are less likely to present with a heart attack, which has a very high risk of a bad outcome, and more likely to present with exercise-induced chest pain or chest pressure, a less deadly form of heart disease."

"While doctors try to prevent coronary disease by treating high blood pressure and high cholesterol, it's not 100 percent effective," said Mark Hlatky, MD, professor of health research and policy and of medicine at Stanford University School of Medicine, the senior author of the study. "If there are warning symptoms like angina with exercise, there is enough time to see a doctor and get started on effective treatments that reduce risk. Having a heart attack causes permanent damage, even if it doesn't kill you."

"I think our study lends additional support to the evidence already out there that statins and beta blockers are effective in heart disease prevention," said Go, of Kaiser Permanente. "Furthermore, it suggests you can decrease the chance of your heart disease being a more severe form if you are taking these medications."