Correlations between prescription of anti-hypertensive medication and mortality due to stroke

BMC Cardiovascular Disorders

Research Article

Albert Csaszar¹  Edit Paulik²  Renata Papp³  Sandor Balogh³ 

[1] 2nd Department of Medicine, Military Hospital State Health Centre, (109-111 Podmaniczky Str.), 1062, Budapest, Hungary;Department of Public Health, Faculty of Medicine, University of Szeged, (10 Dom ter), 6720, Szeged, Hungary;National Institute of Primary Health Care, (84-88 Jasz Str.), 1135, Budapest, Hungary;

关键词: Blood Pressure Level;    Stroke Prevention;    Therapeutic Group;    Stroke Mortality;    Systolic Blood Pressure Level;   

DOI  :  10.1186/1471-2261-12-15

 received in 2011-08-02, accepted in 2012-03-12,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundOne of the most important risk factors for stroke is hypertension. A number of studies have attempted to identify the most effective anti-hypertensive therapeutic group for stroke prevention. Using an epidemiologic approach we aimed to find correlations based on Hungarian data on stroke-mortality and on prescription routine of anti-hypertensive therapeutics in three different counties, showing significant difference in stroke mortality.MethodsWe have used the official yearly reports on stroke-mortality for the period 2003-2008. Based on the significant differences in the change in mortality due to stroke three counties were selected: Baranya, Bekes and Hajdu-Bihar. The usage of antihypertensive therapeutic groups was analyzed. The correlation of stroke mortality difference and different antihypertensive treatment habits was analyzed by using normality test, time series analyses, correlation coefficient, paired samples test, one sample test and chi-square test.ResultsFor the year 2003 stroke-mortality standardized with the county population number was highest in county Bekes, followed by county Baranya and county Hajdu-Bihar. For each year stroke mortality has shown significant (p < 0.0001) difference between the three counties and the ranking/order of the counties has been preserved over time. During the period of our study, an increase in the number of days of treatment was observed for most of the anti-hypertensive drugs listed. We have observed that the increased use of high-ceiling diuretics resulted in a mortality advantage, and the reduction in use of calcium channel blockers with direct cardiac effect had negative consequences.ConclusionsThe authors acknowledge that by limiting the study to three counties the findings cannot be generalized to the whole Hungarian population. Two trends can still be identified:i) increased number of days of treatment (and therefore the probable use) of high-ceiling diuretics is associated with reduction in mortality due to stroke and its immediate complications; ii) reduction in the use of non-dihidropiridin CCBs does not seem justified, as their use appears to be advantageous in stroke prevention. Authors put emphasis on the importance of the adherence of the patients to the preventive therapies. Health care professionals could provide an important added value to the life long preventive therapies by improving the compliance of their patients, giving personalized care and advice.

【 授权许可】

Unknown   
© Papp et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.