Cheaper Heart Disease Drugs are underused

Cheaper Heart Disease Drugs are underused

Reported August 30, 2011

(Ivanhoe Newswire) — A global study reveals that inexpensive drug treatments for cardiovascular disease that have been proven to save lives are substantially underused worldwide. Around 60% of individuals with heart disease and up to half of patients who have had a stroke might not be taking any of the four effective drug types. Underuse of these beneficial treatments is especially common in low-income countries where about 80% of patients reported receiving none of these essential drugs.

The largest study of its kind to date suggests that improvements in the use of these low-cost drugs could substantially reduce global cardiovascular disease within just a few years.

“Even in well-developed health-care systems many patients are not receiving the best secondary prevention treatment, despite a wealth of preventative guidelines, continuing medical education, and revalidation programs”, Anthony Heagerty from The University of Manchester, Manchester, UK in an accompanying Comment, was quoted as saying.

Globally, cardiovascular disease affects more than 100 million people. Despite around 75% of the world’s heart disease and stroke burden occurring in low-income and middle-income countries, little is known about the actual use of preventive drug treatments in these communities.
The PURE study was designed to assess the use of four key secondary preventive and blood-pressure-lowering drugs in the community in three high-income, ten middle-income, and four low-income countries.

Overall, the use of preventive drugs was low. Antiplatelet drugs (mainly aspirin) were taken by only a quarter of individuals with cardiovascular disease, ß-blockers by 17.4%, ACE inhibitors or ARBs by 19.5%, and statins by just 14.6%.

Drug use was highest in high income countries (where about two thirds of patients were taking antiplatelet drugs and statins, and about half of patients ß-blockers and ACE inhibitors or ARBs) and lowest in low-income countries (where less than 10% of patients used these proven therapies).

“Even the use of accessible and inexpensive treatments such as aspirin (the most commonly used antiplatelet drug) varied seven-fold between low-income and high-income countries but the use of statins varied 20-fold,” the authors were quoted as saying.

The economic wealth of a country accounted for two thirds of the variation in drug use, with individual-related factors (such as age, sex, education, smoking, hypertension, and diabetes) affecting the rest.

“Improvements to the uptake of effective secondary prevention strategies are probably more feasible than lifestyle modifications in primary prevention (although both are desirable)…but this will require systematic programs in most countries,” the authors said.

SOURCE: Lancet, August 28, 2011