Author + information
- Jens Sundboll,
- Kasper Adelborg,
- Kathryn Mansfield,
- Laurie Tomlinson and
- Morten Schmidt
Background: Guidelines have changed following new landmark studies on hypertension. Whether use of antihypertensive drugs in clinical practice reflects the temporal changes in guidelines are unknown. We examined long-term trends in the use of antihypertensive drugs in Denmark.
Methods: From nationwide prescription data, we obtained information on primary care use of angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARB), beta blockers, diuretics, aldosterone receptor antagonists and calcium channel blockers (CCBs) during 1999—2015.
Results: During the 17-year period, the use of antihypertensive drugs per 1,000 inhabitants/day increased from 184 to 379 defined daily doses (DDD), corresponding to a rise in the prevalence proportion of users in the entire Danish population from ≈20% to ≈35%. From 1999 to 2015, a notable increase in use was observed for ACE inhibitors (from 29 to 105 DDD per 1,000 inhabitants/day ≈260%) and ARBs (from 13 to 73 DDD per 1,000 inhabitants/day ≈520%). For diuretics the use remained stable, with a slight decreasing tendency (from 89 to 81 DDD per 1,000 inhabitants/day ≈-10%). The use of aldosterone receptor antagonists increased until 2007 and remained unchanged at around 3.5 DDD per 1,000 inhabitants/day thereafter (average change over the whole period ≈65%). The use of beta blockers doubled during the study period (from 17 to 34 DDD per 1,000 inhabitants/day ≈100%), entirely driven by increasing use of metoprolol. Similar trends were observed for CCBs (from 34 to 82 DDD per 1,000 inhabitants/day ≈140%), with amlodipine driving the overall increase.
Conclusions: Antihypertensive drug use has increased remarkably during the past two decades. The change was driven by specific drugs within each class of antihypertensive drugs and correlated with the publication of landmark studies for the medical treatment of hypertension and congestive heart failure.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Strategies for Assessing and Improving Adherence to Blood Pressure Lowering Therapies
Abstract Category: 33. Prevention: Hypertension
Presentation Number: 1275-035
- 2017 American College of Cardiology Foundation