PHARMACOEPIDEMIOLOGY AND PRESCRIPTION Uptake of angiotensin II receptor blockers in the treatment of hypertension

Abstract

Citation for published version (APA): Greving, JP., Denig, P., van der Veen, WJ., Beltman, FW., Sturkenboom, MCJM., de Zeeuw, D., & HaaijerRuskamp, FM. (2005). Uptake of angiotensin II receptor blockers in the treatment of hypertension. European Journal of Clinical Pharmacology, 61(5-6), 461-466. https://doi.org/10.1007/s00228-005-0924-7 Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Abstract Objective: To examine trends in prescribing of angiotensin II receptor blockers (ARBs) as initial and second-line treatment of hypertension. Methods: We performed a cohort study in the Integrated Primary Care Information database, a general practice research database in The Netherlands. We included hypertensive patients who were newly treated with antihypertensive drugs between 1996 and 1999. Initial treatment was defined as the first prescribed antihypertensive drug after diagnosis of hypertension. As secondline treatment, we considered prescriptions of a second antihypertensive drug class, either as switch or addition. We used logistic regression and Cox proportional hazard analysis to estimate time trends in use of ARBs as initial or second-line treatment. Results: In total, 8% of the 3,102 newly treated hypertensive patients received ARBs as initial treatment. Initial ARB use increased significantly from 4% to 10% during the period 1996-1999, whereas calcium channel blocker and angiotensin-converting enzyme inhibitor (ACE-I) use decreased. ARBs were used as second-line treatment in less than 4% of 2,544 patients who were initially treated with an antihypertensive drug other than an ARB: 2% switched to an ARB (mostly from ACE-Is) and 1% received ARBs as add-on treatment. Diuretics and beta-blockers were used five to ten times more often as add-on treatment than ARBs. Conclusion: ARBs achieved a position in the treatment of hypertension as initial rather than second-line therapy

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