Preventive drug use in cardiovascular disease varies with country's economic status
MONDAY, Aug. 29 (HealthDay News) -- The use of preventive drugs for coronary heart disease (CHD) and stroke varies significantly between countries at different stages of economic development, according to a study presented at the European Society of Cardiology Congress held Aug. 27 to 31 in Paris, France and published online Aug. 28 in The Lancet.
Salim Yusuf, D.Phil., from the Hamilton Health Sciences and McMaster University in Canada, and colleagues assessed the use of effective secondary preventive drugs (antiplatelet drugs, β blockers, angiotensin-converting-enzyme [ACE] inhibitors, or angiotensin-receptor blockers [ARBs], and statins) in 5,650 adults with a history of a CHD event, and 2,292 adults with a history of stroke. Participants (aged 35 to 70 years) from 628 urban and rural communities from countries with incomes classified as high, upper-middle, lower-middle, or low. Data were collected through questionnaires completed by telephone interviews, household visits, or during a patient's presentation to a clinic, between 2003 and 2009.
The investigators found that 25.3, 17.4, 19.5, and 14.6 percent of the individuals took antiplatelet drugs, β blockers, ACE inhibitors, ARBs, and statins, respectively. Drug use decreased with decreasing country economic status, with the highest and lowest use in high- and low-income countries, respectively. The proportion of patients receiving no drugs in high-income, upper-middle income, lower-middle income, and low-income countries was 11.2, 45.1, 69.3, and 80.2 percent, respectively. Urban areas had higher drug use than rural areas with the poorest countries showing the greatest variation. The rates of drug use were affected more by country-level factors (including economic status) than by individual-level factors.
"Our study shows the large gap that exists in secondary prevention worldwide, with extremely low rates of use of effective therapies in middle-income and low-income countries," the authors write.
The study and its components were funded by various companies within the pharmaceutical industry.
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