Prescription drug treatment of uncomplicated hypertension doesn’t follow recommendations

Tulokset esitetty keskiarvoina ja prosentteina.

¹Henkilöt, joilla on erityiskorvausoikeus krooniseen verenpainetautiin (Kelan korvausnumero 205).

Background

On average, about 40 percent of the treated hypertensive women, and 50 percent of the men, have blood pressure (BP) levels within current recommendations. Utilization of combination therapy for hypertension has been too low. Beta-blockers are less effective than other antihypertensive drugs in reducing strokes. Beta-blockers are therefore not recommended as a first-line antihypertensive drug for hypertension.

Methods

Comprehensive information on all antihypertensive drugs purchased in Finland was gathered from the database of the Social Insurance Institution of Finland during three months (September, October and November) in the years 2000, 2006 and 2011. We excluded from this study subjects who were eligible for reimbursed medication for diabetes, coronary heart disease, chronic heart failure or chronic cardiac arrhythmias.

Results

In the 11-year period studied the use of antihypertensive medication has increased 2.5-fold among subjects with non-severe hypertension, whereas the number of severely hypertensive subjects treated has remained unchanged. The mean number of antihypertensive drugs per patient increased during the period studied from 
1.4 to 1.6 for subjects with non-severe hypertension and from 2.0 to 2.2 for subjects with severe hypertension. Forty percent of the subjects on monotherapy or dual therapy used beta-blockers, whereas 70 percent of the subjects who were using a combination of at least 3 antihypertensive drugs used beta-blockers.

Conclusions

Treatment of non-severe hypertension has increased following the recommendations of the current evidence-based hypertension guidelines. The use of combination drug therapy in the management of hypertension has also increased but is still not optimal. Beta-blockers are frequently prescribed as a first-line antihypertensive drug for hypertension without a clear medical need.