J-007 ANTI-HYPERTENSIVE MEDICATIONS TRENDS AND RISK OF STROKE AMONG HYPERTENSIVE PATIENTS IN TAIWAN

Abstract

Background To evaluate the trend of anti-hypertensive medications and also examine the risk of stroke among these HTN patients from 2001 to 2005 in Taiwan. Methods Based on the National Health Insurance (NHI) database, we randomly selected 10% hypertension outpatients from the NHI claim database on 2001 and then follow their anti-HTN medications and occurrence of stroke for a 4-year follow-up period. Results In 2001, there are 1931436 patients with ICD-9 coding of hypertension, we selected 194547 subjects as study population, after excluded those visited less than 3 times or without anti-HTN subjects, there are 135660 subjects in the finally analyses. The prevalence of stroke among hypertension patients was slightly decreased from 12.0 to 11.3% since 2001 to 2005 (for male from 20.1 to 19.8 and for females from 17.7 to 16.7%). There are 27.6% patients with only one anti-HTN medication and 37.0% patients with 3 or more medications for HTN. Among these anti-HTN patients, 68.2% used CCB, 55.1% for beta-blocker, and 42.5% with ACEI and 31% with diuretics. Among these patients, 9395 (4402 males and 5128 females) had both information on 2001 and 2004. The prevalence of stoke was 7.3% in 2001 and increased to 13.6% in 2004. Using Cox proportion hazard model, gender (male) and age were important factors to predict the occurrence of stroke. Comparing with beta-blocker, diuretics had higher relative risk for stoke but the risk was attenuate after adjusted for other confounders (HR = 1.3, 95% CI 0.7–2.6). Conclusions From this study, we could found that the occurrence of stroke among hypertensive patients was increased during this period. There was no significant protective effect for stroke among hypertensive patients using different anti-HTN medications. Further studies may be indicated to evaluate the cost-effectiveness of different medications on hypertensive-related disorders.