Abstract
High blood pressure is a major risk factor contributing to death and disability rates in the Baltic states. The aim of this study was to compare the utilization of antihypertensive medicines in Estonia, Latvia and Lithuania from 2008 to 2018. In this retrospective cross-national comparison, nationally representative wholesale data from the IQVIA National Retail Audit were analyzed. The utilization of inhibitors of the renin–angiotensin system, beta blockers, calcium channel blockers, diuretics and centrally acting antihypertensives by Defined Daily Doses per 1000 inhabitants and day (DDD/TID) was used to calculate utilization. Time series analysis was used to analyze trends. The utilization increased annually by 10.88, 8.04 and 6.42 DDD/TID in Estonia, Latvia and Lithuania, respectively, from 2008. The utilization of antihypertensive drugs in 2018 was 372, 267 and 379.5 DDD/TID, respectively. Inhibitors of the renin–angiotensin system were the most commonly used class in 2008 and 2018. From 2008, the utilization of beta blockers and fixed-dose combinations including renin–angiotensin system inhibitors increased substantially, while that of calcium channel blockers decreased. Country-specific utilization trends were noted; e.g., the utilization of centrally acting antihypertensives was 30.9 DDD/TID in Lithuania compared to 3.01 DDD/TID in Estonia and 16.17 DDD/TID in Latvia. The use of antihypertensive medicines increased over the study period, but the trends for the different drug classes differed between countries.
Highlights
Hypertension is one of the leading risk factors in terms of attributable disabilityadjusted life years at the global level [1]
The aim of this study was to compare the utilization of antihypertensive medicines in Estonia, Latvia and Lithuania from 2008 to 2018
Defined daily dose (DDD)/TID in Estonia, 8.04 DDD/TID in Latvia
Summary
Hypertension is one of the leading risk factors in terms of attributable disabilityadjusted life years at the global level [1]. The initiation and continuation of antihypertensive drug therapy are, next to lifestyle changes, the most important measures for blood pressure control to reduce mortality and morbidity from cardiovascular disease (CVD), as outlined in international guidelines [2,3]. There is substantial evidence that antihypertensive drug treatment reduces the risk of cardiovascular morbidity and mortality [4] and is important to improve the early diagnosis and treatment of hypertension. Hypertension treatment has evolved over several decades, driven by the development of various antihypertensive medication. Pharmacoepidemiology 2022, 1 classes [6]. Antihypertensive drug treatment has changed because of the introduction of newer drug classes, drug combinations and subsequent changes in evidence and guideline recommendations [7].
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