Abstract P351: Population-based Trends in Cardiovascular Drug Use for Primary Prevention, Secondary Prevention and Acute Phase Treatment of Coronary Heart Disease, 1998-2010
Background: Guidelines have emphasized prevention of coronary heart disease (CHD) through the use of cardiovascular drugs. The objective of this study was to describe gender-specific time trends in cardiovascular drug use for acute phase treatment, primary and secondary prevention of CHD between 1998 and 2010.
Methods: The Pharmaco-Morbidity (PHARMO) database was used for record linkage of drug dispensing, hospitalization and population data to identify cardiovascular drug use and revascularization procedures in over 1.2 million residents aged ≥25 years in the Netherlands.
Results: The use of anti-hypertensive drugs for primary prevention of CHD increased from 11% in 2003 to 16% in 2010 in men and from 14% to 17% in women. Likewise, the use of statins increased from 5% to 9% in men and from 4% to 7% in women. The use of cardiovascular drugs during hospital admission for acute myocardial infarction increased between 1998 and 2010, most pronounced for thienopyridines (4% to 92%) and statins (23% to 88%). Nevertheless, continuation rates of cardiovascular drug use after hospital discharge for acute coronary syndrome were low in both men and women. Moreover, no large improvements were observed in the secondary prevention setting between 1998 and 2010, except for angiotensin receptor blockers (ARBs) and statins. Three years after hospital discharge for acute coronary syndrome in 2007, cardiovascular drug use of aspirin, statins and beta-blockers was 50%, 52% and 48%, respectively.
Conclusions: The use of cardiovascular drugs in the Netherlands increased for primary prevention and during acute phase treatment of CHD. However, secondary prevention therapy of CHD is still falling short. Greater attention is needed in order to increase treatment levels after hospital discharge for acute coronary syndromes.
- © 2013 by American Heart Association, Inc.