Antihypertensive drug treatment in a Swedish community:: Skaraborg Hypertension and Diabetes Project

Purpose To describe and compare the pattern of antihypertensive drug prescriptions during different time periods. Methods Antihypertensive prescriptions were registered in all patients who underwent an annual follow-up during 1998 (n = 984), 1992-1993 (n = 924), and 1981 (n = 689), at the hypertension outpatient clinic in primary health care. Skara, Sweden. Results From 1981 to 1998 the total prescriptions of thiazides declined from 61 to 10% (p < 0.001), whilst prescriptions of calcium antagonists increased from 4 to 30% (p < 0.001), and ACE inhibitors from zero to 23% (p < 0.001). Prescriptions of calcium antagonists and ACE inhibitors increased during 1990-1995. but during 1996-1998 a significant decrease in primary prescriptions of calcium antagonists was demonstrated (OR: 0.15; 95% Cl: 0.06-0.36). During all periods, females were more frequently treated with older types of antihypertensive drugs than males. In the analysis of total prescriptions in 1998 women were prescribed calcium antagonists (OR: 0.59: 95% Cl: 0.45-0.78) and ACE inhibitors (OR: 0.43 95% CI: 0.31-0.58) less frequently than men. Conclusion There were significant changes in type of antihypertensive drugs used, both by time and between genders. Changes during the latest years indicate that the prescription pattern can be greatly influenced by new scientific reports and economic debate. Copyright (C) 2002 John Wiley & Sons, Ltd.