‘Concerningly Low’ Use of CVD Meds for Secondary Prevention

TOPLINE:

Among patients with ­cardiovascular disease (CVD) in 17 countries, many receive no medication for secondary prevention, a study showed. Overall use of medications for secondary prevention decreased from 41.3% to 31.3% over a 12-year study, with trends varying by income level of the countries in the analysis.

METHODOLOGY:

• Researchers analyzed data from 17 countries in the Prospective Urban Rural Epidemiology cohort study, which included 7409 participants at baseline in 2007 (median age, 58 years) and 11,677 participants by the final visit.
• The researchers examined whether participants with coronary artery disease used antiplatelet agents, statins, renin-angiotensin system inhibitors, or beta-blockers. For participants with stroke, they assessed the use of antiplatelet agents, statins, renin-angiotensin system inhibitors, and other drugs to lower blood pressure.
• Countries were categorized as high-income (Canada, Sweden, and United Arab Emirates), upper-middle-income (Argentina, Brazil, Chile, Malaysia, Poland, South Africa, and Turkey), lower-middle-income (China, Colombia, and Iran), and low-income (Bangladesh, India, Pakistan, and Zimbabwe) based on World Bank classification at the start of the study.

TAKEAWAY:

• The use of medications for secondary prevention of CVD peaked at 43.1% during the second visit but declined to 31.3% by the final visit.
• In upper-middle-income countries, medication use increased from 55% to 61.1%.
• In lower-middle-income countries, medication use fell from 29.5% to 13.4%.
• At the final visit, 13.5% of participants were receiving drugs in three or more classes of medication.

IN PRACTICE:

“Achieving optimal secondary prevention via pharmacotherapy usually requires three or more medications. The overall use of three or more medicines in this study was concerningly low,” wrote Abhishek Chaturvedi, MD, and Dorairaj Prabhakaran, MD, with the Center for Chronic Disease Control in New Delhi, India, in an editorial commenting on the study.

SOURCE:

Philip Joseph, MD, with McMaster University and Hamilton Health Sciences in Hamilton, Ontario, Canada, was the corresponding author for the study. The research was published in the February 11 issue of Journal of the American College of Cardiology.

LIMITATIONS:

The last study visits occurred between 2018 and 2020, so the COVID-19 pandemic might have influenced certain results.

DISCLOSURES:

The PURE study received funding from the Population Health Research Institute, the Hamilton Health Sciences Research Institute, the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Ontario, and several pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.