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Coronary artery disease and the contours of pharmaceuticalization

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  • Pollock, Anne
  • Jones, David S.

Abstract

Coronary artery disease (CAD) has dominated mortality for most of the past century, not just in Europe and North America but worldwide. Treatments for CAD, both pharmaceutical and surgical, have become leading sectors of the healthcare economy. This paper focuses on the therapeutic landscape for CAD in the United States. We hope to add texture to the broader conversation of pharmaceuticalization explored in this issue by situating pharmaceutical therapies as just one element in the broader therapeutic terrain, alongside cardiac surgery and interventional cardiology. Patients with CAD must navigate a therapeutic landscape with three intersecting paths: lifestyle change, pharmaceuticals, and surgery. While pharmaceuticals are often seen as a quick fix, a way of avoiding more difficult lifestyle changes, it is surgery and angioplasty that promise patients the quickest fix of all. There also is another option, often overlooked by analysts but popular among physicians and patients: inaction. The U.S. context is often critiqued as a site of excessive treatment with respect to both drugs and procedures, and yet there is deep stratification within it – over-treatment in many populations and under-treatment in others. People who experience the serious risks of CAD do so in a racialized terrain of durable preoccupations with difference and unequal access to care. While the pharmaceuticalization literature disproportionately attends to lifestyle drugs, which some observers consider to be medically inappropriate or unnecessary, CAD does remain the leading cause of death. Thus, the stakes are high. Examination of the pharmaceuticalization of CAD in light of surgical treatments and racial disparities offers a window into the pervasiveness and persuasiveness of pharmaceuticals in an increasingly consumer-driven medicine, as well as the limits of their appeal and their reach.

Suggested Citation

  • Pollock, Anne & Jones, David S., 2015. "Coronary artery disease and the contours of pharmaceuticalization," Social Science & Medicine, Elsevier, vol. 131(C), pages 221-227.
  • Handle: RePEc:eee:socmed:v:131:y:2015:i:c:p:221-227
    DOI: 10.1016/j.socscimed.2014.06.035
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    References listed on IDEAS

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    1. repec:aph:ajpbhl:10.2105/ajph.2013.301226_7 is not listed on IDEAS
    2. Das, Aniruddha, 2013. "How does race get “under the skin”?: Inflammation, weathering, and metabolic problems in late life," Social Science & Medicine, Elsevier, vol. 77(C), pages 75-83.
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    4. Frosch, Dominick L. & May, Suepattra G. & Tietbohl, Caroline & Pagán, José A., 2011. "Living in the “land of no”? Consumer perceptions of healthy lifestyle portrayals in direct-to-consumer advertisements of prescription drugs," Social Science & Medicine, Elsevier, vol. 73(7), pages 995-1002.
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    6. Bell, Susan E. & Figert, Anne E., 2012. "Medicalization and pharmaceuticalization at the intersections: Looking backward, sideways and forward," Social Science & Medicine, Elsevier, vol. 75(5), pages 775-783.
    7. Weiner, Kate, 2010. "Configuring users of cholesterol lowering foods: A review of biomedical discourse," Social Science & Medicine, Elsevier, vol. 71(9), pages 1541-1547, November.
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    Cited by:

    1. Unruh, Lynn & Rice, Thomas & Rosenau, Pauline Vaillancourt & Barnes, Andrew J., 2016. "The 2013 cholesterol guideline controversy: Would better evidence prevent pharmaceuticalization?," Health Policy, Elsevier, vol. 120(7), pages 797-808.

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