Variations and increase in use of statins across Europe: data from administrative databases

Walley, Tom; Folino-Gallo, Pietro; Schwabe, Ulrich; Ganse, Éric Van

doi:10.1136/bmj.328.7436.385

Cited by 115 publications

(79 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A later comparison of the diabetes populations in two Swedish neighbouring towns indicated that glucose control was better in the town in which AHGD use was more extensive [15]. Based on these findings, and as recent studies have revealed very large differences between European countries in terms of the utilisation of other drugs, such as antibiotics [16] and statins [17], the aim of the present study was to update and compare the utilisation of insulin and oral AHGDs in a number of European countries where such data were available.…”

Section: Introductionmentioning

confidence: 82%

Utilisation of antihyperglycaemic drugs in ten European countries: different developments and different levels

et al. 2006

View full text Add to dashboard Cite

Aims/hypothesis The aim of this study was to compare developments in the utilisation of antihyperglycaemic drugs (AHGDs) in ten European countries. Subjects and methods Data on the yearly utilisation of insulin and oral AHGDs were collected from public registers in Denmark, Finland, Norway, Sweden, Belgium, England, Germany, Italy, Portugal and Spain, and were expressed as defined daily doses per 1,000 inhabitants per day. Results Total AGHD utilisation increased everywhere, but at different rates and levels. Insulin utilisation doubled in England and Germany, but hardly changed in Belgium, Portugal or Italy. Sulfonylurea utilisation doubled in Spain, England and Denmark but was reduced in Germany and Sweden. Metformin utilisation increased greatly everywhere. There were two-to three-fold differences in AHGD utilisation even between neighbouring countries. In Finland, there were more users of both insulin (+120%) and oral AHGDs (+80%) than in Den- Diabetologia (2006) mark, and the daily oral AHGD doses were higher. In Denmark and Sweden, AHGD utilisation was equal in subjects aged <45 years, but in those ≥45 years of age, both insulin and oral AHGD utilisation were twice as high in Sweden. Conclusions/interpretation The ubiquitous increase in AHGD utilisation, particularly metformin, seems logical, considering the increasing prevalence of type 2 diabetes and the results of the UK Prospective Diabetes Study. However, the large differences even between neighbouring countries are more difficult to explain, and suggest different habits and attitudes in terms of screening and management of type 2 diabetes.

show abstract

Section: Introductionmentioning

confidence: 82%

Utilisation of antihyperglycaemic drugs in ten European countries: different developments and different levels

et al. 2006

View full text Add to dashboard Cite

show abstract

“…However, whereas implementation of the guidelines could imply a larger part of the population on cardiovascular preventive therapy in the future [5,6], variation in lipid-lowering drug (LLD) sales across Scandinavia and the rest of Europe may reflect uncertainty about how to manage existing guidelines in clinical practice [7]. The variations in LLD use between countries have been little investigated, but may be explained by differences in national treatment guidelines and drug reimbursement systems, as well as variations in cardiovascular morbidity [8,9].…”

mentioning

confidence: 99%

“…The sales of LLDs have increased remarkably in Norway since 1994 and are high compared with other European countries [7,10,11]. However, within Norway the inter-county variations in LLD sales have been large and persistent ( Figure 1) [11].…”

mentioning

confidence: 99%

Why do sales of lipid-lowering drugs vary between counties in Norway?

Hartz

Njølstad

Furu

et al. 2006

Scandinavian Journal of Primary Health Care

View full text Add to dashboard Cite

“…Inhibitors of 3hydroxy3methylglutaryl-coenzyme A reductase (statins) are the most effective and widely used cholesterol-lowering drugs in industrialized countries. 2 They significantly reduce the risk of cardiovascular events and death in both primary and secondary prevention of cardiovascular disease. 3,4 Although the long-term benefit by statin treatment is largely attributed to their cholesterol-lowering action, increasing attention focuses on additional actions of these substances, which are independent from 3hydroxy3methylglutaryl-coenzyme A reductase inhibition 5 and might help explain why part of the benefit in terms of cardiovascular protection is already seen shortly after the initiation of therapy.…”

mentioning

confidence: 99%

Do Statins Reduce Blood Pressure?

et al. 2007

View full text Add to dashboard Cite

Abstract-A meta-analysis was performed of the effect of 3hydroxy3methylglutaryl-coenzyme A reductase inhibitors (statins) on blood pressure in humans including the randomized, controlled trials of statin therapy (20 trials and 828 patients) in which concomitant antihypertensive treatment (if any) remained unchanged throughout the study. A total of 291 and 272 patients were given a statin or placebo, respectively, in parallel group trials, whereas 265 took part in crossover trials receiving a statin and placebo (or probucol, in 1 trial). Systolic blood pressure was significantly lower in patients on statin than in those on placebo or control hypolipidemic drug (mean difference: Ϫ1.9 mm Hg; 95% CI: Ϫ3.8 to Ϫ0.1). The effect was greater when the analysis was restricted to studies with a baseline systolic blood pressure Ͼ130 mm Hg (⌬ systolic blood pressure: Ϫ4.0; 95% CI: Ϫ5.8 to Ϫ2.2 mm Hg). There was a trend for lower diastolic blood pressure in patients receiving statin therapy compared with control: Ϫ0.9 mm Hg (95% CI: Ϫ2.0 to 0.2) overall and Ϫ1.2 mm Hg (95% CI: Ϫ2.6 to 0.1) in studies with a baseline diastolic blood pressure Ͼ80 mm Hg. In general, the higher the baseline blood pressure, the greater the effect of statins on blood pressure (Pϭ0.066 for systolic blood pressure and Pϭ0.023 for diastolic blood pressure). The blood pressure response to statins was unrelated to age, changes in serum cholesterol, or length of the trial. In conclusion, statin therapy has a relatively small but statistically significant and clinically meaningful effect on blood pressure. Key Words: blood pressure Ⅲ hypertension, arterial Ⅲ hypercholesterolemia Ⅲ drug therapy Ⅲ statins Ⅲ meta-analysis H igh blood pressure (BP) is common in hypercholesterolemic and in diabetic patients and powerfully contributes to the increase in cardiovascular risk. 1 The prescription of both antihypertensive and cholesterol-lowering drugs is generally required for these patients. Inhibitors of 3hydroxy3methylglutaryl-coenzyme A reductase (statins) are the most effective and widely used cholesterol-lowering drugs in industrialized countries. 2 They significantly reduce the risk of cardiovascular events and death in both primary and secondary prevention of cardiovascular disease. 3,4 Although the long-term benefit by statin treatment is largely attributed to their cholesterol-lowering action, increasing attention focuses on additional actions of these substances, which are independent from 3hydroxy3methylglutaryl-coenzyme A reductase inhibition 5 and might help explain why part of the benefit in terms of cardiovascular protection is already seen shortly after the initiation of therapy. 6,7 Very few relatively small studies have investigated the antihypertensive effect of statins in patients with hypertension associated with hypercholesterolemia. 8 -10 The results of 2 recently published large statin studies, albeit not designed to answer this question, have attracted the interest on this subject. 11,12 Many other studies, also not specifically aimed at ...

show abstract

Variations and increase in use of statins across Europe: data from administrative databases

Cited by 115 publications

References 3 publications

Utilisation of antihyperglycaemic drugs in ten European countries: different developments and different levels

Utilisation of antihyperglycaemic drugs in ten European countries: different developments and different levels

Why do sales of lipid-lowering drugs vary between counties in Norway?

Do Statins Reduce Blood Pressure?

Contact Info

Product

Resources

About