How much do doctors treat heart disease?

If you have heart disease, you probably follow your doctor's treatment plan, as you should do.

However, you should also be aware that, according to a new study, more than 90% of recommendations for treatment of heart disease stem from less solid scientific evidence: evidence from a single trial or from observational badyzes , or the opinion of experts.

The study, published today in JAMA, found that only 8.5% of doctors' treatment recommendations for people with heart disease are based on reference research, which means that the evidence is based on several large randomized clinical trials.

The researchers in the study examined the scientific evidence behind more than 6,300 recommendations from the American College of Cardiology, the American Heart Association and the European Society of Cardiology. They followed a 2009 study that found that 11% of treatment recommendations met the gold standard.

What proved successful

This does not mean, of course, that not all treatment plans lack solid evidence. Experts say that the following diagrams are well supported:

Prescription Drugs. All drugs must be the subject of serious research before the FDA approves them for the market. "Look at how we've reduced the number of heart attacks since statin extinction. There is good evidence that statins are partly responsible for this, "says Nieca Goldberg, Medical Director of the Joan H. Tish Center for Women's Health at NYU Langone Medical Center.

Exercise regularly and stop smoking. There is ample evidence that people who exercise and are active lead a longer and healthier life, says Goldberg. Smoking, of course, is bad for many reasons, not just for the health of your heart.

Daily aspirin. "The evidence is very strong for aspirin in people with existing heart or vascular disease," says Goldberg. And studies are refining the recommendations for using aspirin for others.

According to lead author Alexander Fanaroff, an interventional cardiologist at the Duke Clinical Research Institute, there is also reasonable evidence of medical devices such as internal defibrillators and pacemakers.

Where the evidence is missing

In contrast, an area in which doctors generally give advice – the diet – lacks solid evidence for developing a treatment plan, says Fanaroff. Controlling your sodium is an area for which we do not have good evidence, he says.

Fanaroff also stated that there is also little evidence for treatment of valvular heart disease, a condition in which one of the four heart valves is defective or otherwise damaged. The same goes for the treatment of conbad heart disease in adults: "Less than 2% [of treatments] are supported by evidence from randomized controlled trials. "

This is because under such conditions, there are simply not as many people to study. It is easier to look for high blood pressure and cholesterol levels because many people suffer from these conditions.

In fact, the most studied domains in randomized controlled trials benefited more from baseline research. Yet they came in below 33%.

Ask the right questions

Given the lack of strong evidence for some treatments, it is important to pressure your doctors for details.

Peter Reyes, a Heart Center at Mercy cardiologist in Baltimore, explains that doctors who consult the treatment guidelines can see what the strength of the recommendation is and the evidence behind it. So talk to your doctor about your illness or treatment.

Ask: "In your best calculation, what are the risks and benefits of the therapy you recommend?" Says Goldberg.