Heart disease and stroke are the leading causes of death globally. Most people who have had a heart attack or stroke should receive medicines that, lower blood pressure, lower blood cholesterol, and prevent blood clots (e.g. aspirin). Previous evidence, from a decade ago, from the United Kingdom indicated underuse of these medicines in patients who should be receiving them. It is unknown if the situation has improved since then. Generally, these medicines are to be taken long term, therefore simplification of therapy is critical to long term adherence to them. We propose to study, the extent to which these medicines are co-prescribed, i.e. compliance with guideline recommendations to prescribe all three treatments simultaneously, and to assess their association with blood pressure and cholesterol levels when they are used alone and together. This information will inform strategies to increase uptake of these recommended medicines including the potential use of fixed dose combinations for patients with heart disease and stroke.
Most people with or at high risk of cardiovascular disease (CVD) need long term treatment with drugs for lowering blood pressure (BP), lowering cholesterol, and for platelet aggregation inhibition (e.g. aspirin) as recommended by guidelines major clinical practice guidelines. In such patients, simplification of treatment is critical to long term adherence to these drugs. Typically, data are reported on the rate of prescription of each of these treatments modalities separately. However, few data are available on co-prescription, i.e. concordance with guideline recommendations to prescribe all treatments simultaneously. And furthermore, there are limited data on whether risk factor changes are affected by concomitant use of these drugs. We propose therefore to estimate using an observational cohort study design, the prevalence of use of drugs for BP lowering, cholesterol lowering and aspirin, and to assess their associations with BP and cholesterol levels when they are used alone and together. Data will be analysed using descriptive and inferential statistics including linear regression analysis models. Information from this research will inform strategies to increase uptake of recommended treatments and use of fixed dose combinations (FDCs) for patients with heart disease and stroke.
Distribution of variables including patient characteristics (e.g., age, sex history of cardiovascular disease and diabetes, smoking, number of GP visits), prescriptions (blood pressure-lowering drugs, lipid-modifying drugs, aspirin), mean blood pressure, mean lipid levels)
Kazem Rahimi - Chief Investigator - The George Institute for Global Health
Kazem Rahimi - Corresponding Applicant - The George Institute for Global Health
Abdul Salam - Collaborator - The George Institute for Global Health
Anthony Rodgers - Collaborator - The George Institute for Global Health
Dexter Canoy - Collaborator - The George Institute for Global Health
Emily Atkins - Collaborator - The George Institute for Global Health
Mariagrazia Zottoli - Collaborator - The George Institute for Global Health