(Circulation. 1999;99:2055-2057.)
© 1999 American Heart Association, Inc.
Current Perspective |
Trends in Antihypertensive Drug Advertising, 1985–1996
From the Institute for Health Policy and General Medicine Division, Massachusetts General Hospital, Medical Services and Department of Medicine, Harvard Medical School, Boston, Mass.
Background—Over the past decade, calcium channel blockers (CCBs) and ACE inhibitors have been used increasingly in the treatment of hypertension. In contrast, ß-blocker and diuretic use has decreased. It has been suggested that pharmaceutical marketing has influenced these prescribing patterns. No objective analysis of advertising for antihypertensive therapies exists, however.
Methods and Results—We reviewed the January, April, July, and
October issues of the New England Journal of Medicine
from 1985 to 1996 (210 issues). The intensity of drug promotion was
measured as the proportion of advertising pages used to promote a given
medication. Statistical analyses used the 
2 test
for trend. Advertising for CCBs increased from 4.6% of advertising
pages in 1985 to 26.9% in 1996, while advertising for ß-blockers
(12.4% in 1985 to 0% in 1996) and diuretics (4.2% to 0%)
decreased (all P<0.0001). A nonsignificant increase was
observed in advertising for ACE inhibitors (3.5% to 4.3%,
P=0.17). Although the total number of drug advertising
pages per issue decreased from 60 pages in 1985 to 42 pages in 1996
(P<0.001), the number of pages devoted to calcium
channel blocker advertisements nearly quadrupled.
Conclusions—Increasing promotion of CCBs has mirrored trends in physician prescribing. An association between advertising and prescribing patterns could explain why CCBs have supplanted better-substantiated therapies for hypertension.
Key Words: hypertension • practice patterns • drug therapy • advertising
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