Cardiovascular diseases such as hypertension, dyslipidaemia and heart disease often require long-term treatment and consistent monitoring to keep risk factors under control and reduce the likelihood of serious complications. However, skipping doses, stopping medication once symptoms improve or taking other medicines without medical advice can compromise treatment outcomes.
In this interview with Health Xplore India, Dr Mayanka Lodha Seth, chief pathologist at Redcliffe Labs, discusses why medication adherence matters in cardiovascular care, the common barriers patients face and the precautions they should take when using other medicines or supplements. She also highlights the role of lifestyle modifications, regular monitoring and recognising warning signs that require prompt medical attention.
Q1. What are the key things people diagnosed with cardiovascular disease should keep in mind as part of their long-term disease management?
Long-term care of cardiovascular disease requires continuous monitoring, as these disorders can worsen without visible signs. Patients are advised by their treating physicians to monitor blood pressure, cholesterol, blood sugar levels and renal function. These assessments help to find out how effectively condition management is working and whether the treatment plan may need any modifications.
Regular follow-up consultations are equally crucial, providing doctors with an opportunity to examine test findings and analyse changes in a patient’s health, as well as address potential issues early on. Patients also need to maintain a log of their reports and mention any new symptoms or concerns while consulting. Regular monitoring and prompt medical advice can allow patients to know about their cardiovascular risk and manage their health over a span of time.
Q2. How important is medication adherence in controlling cardiovascular risk? What can happen if patients skip prescribed medicines, change doses on their own, or stop treatment once they feel better?
Medication adherence is key to reducing cardiovascular risk, especially for those with high blood pressure, high cholesterol, or established heart disease. These disorders may develop with no evident symptoms, and recommended drugs assist in regulating risk factors and lower the chance of significant complications. Research shows that about half of the patients do not follow the recommended medication use, indicating the importance of increased knowledge and regular follow-up.
Skipping doses or altering dosages, or quitting therapy because you feel better, might upset disease control and raise the risk of heart attacks, strokes and hospitalisation. Patients should talk to their doctors about side effects, costs or concerns, and not change their therapy themselves. Regular drug use, monitoring and informed lifestyle choices are key to long-term heart health.
Q3. What are some common reasons patients discontinue or irregularly take their cardiovascular medicines, and how can these barriers be addressed?
Non-adherence to medication is generally due to a combination of financial restrictions, fears about side effects, complex treatment schedules, and little information about the problem. Hypertension and high cholesterol may not create apparent symptoms, so patients may conclude they no longer require medicine once they start feeling better. Others may have difficulty affording long-term treatment or remembering to take their medications in the course of their daily lives.
Overcoming these hurdles needs clear and transparent patient education, regular follow-ups, and open communication with healthcare professionals. Patients should speak with their healthcare provider about any adverse effects or cost issues, rather than stopping the medication on their own. Simplifying prescription regimens, employing reminders and involving family members might assist too. Improving access to affordable medicines and routine monitoring is equally important for sustained cardiovascular care.
Q4. Are there any over-the-counter medicines, supplements, or herbal products that people taking cardiac medications should be cautious about?
Of course, anyone taking cardiac medication should inform their doctor about any over-the-counter medicines, supplements or herbal remedies they are using. Many of these products can be used safely; however, some may interact with prescribed medicines, affect blood pressure or increase the risk of side effects. The danger of this varies with the product, the dose and the treatments a person is taking. Some herbal remedies and supplements can also impact blood coagulation or change how some cardiac drugs work.
Patients should thus avoid self-medication and check with their doctor or pharmacist before taking a new product, particularly if they are taking blood thinners or medicines for blood pressure. It is equally important not to discontinue prescribed cardiac medication without medical advice.
Q5. Which commonly used medicines—for example, painkillers, cold and cough medicines or antacids—can potentially interfere with cardiovascular medicines?
Some drugs routinely used can interact with your cardiovascular treatment. For example, medications like Ibuprofen and Diclofenac can increase blood pressure and cause fluid retention, especially if taken repeatedly. Medications for cold and flu that contain decongestants, such as pseudoephedrine or phenylephrine, can also raise blood pressure and heart rate. Some treatments for acidity can interfere with the absorption and metabolism of some cardiac drugs. For example, Omeprazole might interact with Clopidogrel, a medication used to prevent blood clots.
But these hazards depend on the substance, the dose, and the treatment indicated for the patient. Patients should talk to their doctor before using these medicines, even for short-term comfort and should not stop or change their prescribed cardiac medication on their own.
Q6. What should patients do if they suspect a drug interaction or experience side effects after starting a new medicine?
If the patient experiences an adverse reaction or an unexpected side effect after starting a new medication, they should call the prescribing physician immediately. They should write down the symptoms and when they started, any recent changes in dose, and all the medications and supplements they are taking. Patients should not stop or change prescribed medicine without guidance from their doctor, as this may influence the care of the underlying problem.
But there are some symptoms that need to be treated right away and should not be looked at as ordinary side effects. These include trouble breathing, swelling of the face or throat, heavy bleeding, or chest pain. Patients with these symptoms should seek emergency care immediately. Suspected adverse medication reactions can also be reported in India through the Pharmacovigilance Program of India (PvPI). This type of reporting helps to better monitor the safety of medicines and detect possible dangers.
Q7. How important is it for patients to inform their doctor or pharmacist about all medicines and supplements they are taking before starting a new drug?
Patients should tell their doctor about all the drugs and supplements they are taking before starting a new drug. This is extremely important. This includes prescription drugs, over-the-counter products, vitamins and Ayurvedic or herbal cures.
There are certain drug combinations that may diminish the effectiveness of a therapy, worsen side effects or trigger dangerous interactions. For example, some painkillers can raise the risk of bleeding for people on blood-thinning medications, and some supplements can also interfere with how these medicines work.
Healthcare practitioners are able to help detect potential hazards, prevent duplicate substances, and select the most appropriate treatment by keeping an up-to-date list of all medicines and discussing it during a consultation. Patients should remember that even products considered natural or commonly available may interact with prescribed medicines. Open communication is an easy but important step toward safer treatment and improved health results.
Q8. For people who have been prescribed long-term cardiovascular medicines, what is the best way to keep track of medication schedules, follow-up appointments and test results?
For people taking cardiovascular medicines over the long term, consistency and organisation are both necessary. Maintaining a written or digital medication record with the names, doses and timings of the medicines can help prevent missed or duplicate doses. Phone alarms, medication reminder apps, or a weekly pill organiser can make daily routines easier, particularly for older adults.
Patients should also maintain a calendar for follow-up appointments and keep prescriptions, blood pressure readings, blood test results and reports such as ECGs and echocardiograms in one location, either in a digital or physical folder, in an orderly manner.
Sharing these details with your cardiologist during appointments allows you to track any changes over time and contribute to timely treatment decisions. But most essential, patients should take drugs as recommended and never modify doses or discontinue treatment without visiting their doctor.
Q9. Are there any dietary or lifestyle practices that people with cardiovascular disease should avoid or approach with caution?
Those with cardiovascular disease should be aware of their food choices and lifestyle activities that could cause stress to the heart. Excess salt, frequent consumption of deep-fried and highly processed foods, excessive saturated fats and sugary drinks can contribute to high blood pressure, unhealthy cholesterol levels, diabetes and weight gain. Pickles, papads and packaged snacks can also include hidden salt; therefore, it is better to examine the nutrition labels and choose home-cooked food with less salt and oil.
Lifestyle choices are equally important. Tobacco usage, deprivation of sleep and physical inactivity can increase the cardiovascular risk. Regular physical activity is good for you, but if you have cardiac problems, you should not abruptly start rigorous exercise without medical assistance, and you should have an exercise plan suitable for your condition. Unregulated supplements and self-medication should also be approached with caution, as some products can interact with prescribed cardiac medicines.
Most importantly, patients should not discontinue or alter their medication, or make major changes in their diet without an expert’s consultation. A well-balanced, sustainable diet, regular follow-ups, and an individually tailored lifestyle plan can help support heart health in the long run, alongside medical treatment.
Q10. What symptoms should never be ignored in someone with cardiovascular disease, and when should they seek emergency medical attention?
People with cardiovascular disease should never ignore new, persistent or worsening symptoms, even if they appear like acidity, indigestion, or routine fatigue. Chest pain, pressure or tightness, especially if it spreads to the arms, shoulder, jaw, neck, or back, may signal a heart attack. Other warning indications include abrupt breathlessness, cold sweats, nausea, unexplained exhaustion, dizziness, fainting, and a rapid or irregular heart rate. Persistent cough, swelling in the legs or ankles, and sudden weight gain may also indicate worsening heart failure.
Emergency medical attention is the first move to take if someone experiences chest discomfort lasting more than a few minutes or recurring episodes, especially when accompanied by sweating, breathlessness, or pain spreading to the arm or jaw. Sudden severe breathlessness, fainting, or rapidly worsening swelling also requires urgent examination. In such situations, you can dial 112 or the local ambulance service immediately. Do not wait for symptoms to subside, rely on home remedies, or drive yourself to the hospital.
