Cardiovascular disease management in people with diabetes outside North America and Western Europe in 2006 and 2015.
Aged
Antihypertensive Agents
/ therapeutic use
Diabetes Mellitus, Type 2
/ drug therapy
Diabetic Angiopathies
/ drug therapy
Dyslipidemias
/ drug therapy
Europe
/ epidemiology
Female
Health Surveys
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Hypertension
/ drug therapy
Male
Middle Aged
North America
/ epidemiology
Journal
Diabetic medicine : a journal of the British Diabetic Association
ISSN: 1464-5491
Titre abrégé: Diabet Med
Pays: England
ID NLM: 8500858
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
accepted:
02
11
2018
pubmed:
8
11
2018
medline:
23
5
2020
entrez:
8
11
2018
Statut:
ppublish
Résumé
Optimal treatment of cardiovascular disease is essential to decrease mortality among people with diabetes, but information is limited on how actual treatment relates to guidelines. We analysed changes in therapeutic approaches to anti-hypertensive and lipid-lowering medications in people with Type 2 diabetes from 2006 and 2015. Summary data from clinical services in seven countries outside North America and Western Europe were collected for 39 684 people. Each site summarized individual-level data from outpatient medical records for 2006 and 2015. Data included: demographic information, blood pressure (BP), total cholesterol levels and percentage of people taking statins, anti-hypertensive medication (angiotensin-converting enzyme inhibitors, calcium channel blockers, angiotensin II receptor blockers, thiazide diuretics) and antiplatelet drugs. From 2006 to 2015, mean cholesterol levels decreased in six of eight sites (range: -0.5 to -0.2), whereas the proportion with BP levels > 140/90 mmHg increased in seven of eight sites. Decreases in cholesterol paralleled increases in statin use (range: 3.1 to 47.0 percentage points). Overall, utilization of anti-hypertensive medication did not change. However, there was an increase in the use of angiotensin II receptor blockers and a decrease in angiotensin-converting enzyme inhibitors. The percentage of individuals receiving calcium channel blockers and aspirin remained unchanged. Our findings indicate that control of cholesterol levels improved and coincided with increased use of statins. The percentage of people with BP > 140/90 mmHg was higher in 2015 than in 2006. Hypertension treatment shifted from using angiotensin-converting enzyme inhibitors to angiotensin II receptor blockers. Despite the potentially greater tolerability of angiotensin II receptor blockers, there was no associated improvement in BP levels.
Identifiants
pubmed: 30402961
doi: 10.1111/dme.13858
pmc: PMC6618273
doi:
Substances chimiques
Antihypertensive Agents
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
878-887Informations de copyright
© 2018 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
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