For some patients, the initiation of pharmacological therapy for the prevention of cardiovascular disease provides an incentive to adhere to a healthy lifestyle. Others, however, seem to perceive medication to be a substitute for lifestyle modifications. Researchers conducted an observational study of Finnish public sector employees to determine whether the initiation of antihypertensive or lipid-lowering (statin) therapy changes lifestyle factors.

The study population comprised 41,225 people who were age 40 or older, did not have cardiovascular disease at baseline, and responded to at least two consecutive surveys administered at four-year intervals. Medication use was assessed based on pharmacy claims.

Using standard questionnaires, the researchers assessed height, weight, physical activity, weekly alcohol consumption, and smoking status. They then compared these lifestyle factors in 8,837 "initiators" (people who filled at least one prescription for any preventive medication for the first time between the baseline and second surveys) and 46,021 "noninitiators" (those who didn't fill any prescriptions during this time period). The initiators experienced a greater increase in body mass index compared with the noninitiators. The odds of becoming obese by the time of the second survey were higher among the initiators, whether or not they were obese when first surveyed. Physical activity declined between surveys in the initiator group compared with the noninitiator group, and the former were more likely to be physically inactive at the time of the second survey regardless of baseline activity levels. In contrast, the initiators had a greater increase in alcohol consumption and the prevalence of smoking than the noninitiators.

The authors point out that the study participants were a relatively homogeneous group, so the results may not apply to other populations. In addition, intensive public health initiatives occurring during the study period may have influenced the lifestyles of those studied. The authors also note that they didn't have information about each person's dietary intake and risk factors, or whether they used the dispensed medicine.