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December 30, 2008Hypertension127 citations

Increases in Antihypertensive Prescriptions and Reductions in Cardiovascular Events in Canada

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NCNorm R.C. CampbellRBRollin BrantHJHelen Johansen

Key Result

Increases in antihypertensive prescriptions were associated with significant reductions in death from stroke, heart failure, and myocardial infarction (P<0.001 for all 3 diseases).

Key Points

  • The study aims to assess the relationship between antihypertensive prescription increases and changes in cardiovascular outcomes in Canada from 1992 to 2003.
  • Analyzed national databases to calculate mortality and hospitalization rates per 1000 for cardiovascular diseases.
  • Examined changes in rates using time series analysis.
  • Focused on individuals aged 20 years and older.
  • Significant reductions in death rates from stroke, heart failure, and myocardial infarction starting in 1999 (P<0.0001).
  • Reduction in hospitalization rates for stroke and heart failure (P<0.0001), but no significant change for myocardial infarction.
  • Increases in antihypertensive prescriptions were significantly associated with reductions in mortality (P<0.001) and hospitalization rates.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

Do increases in antihypertensive prescriptions reduce hospitalization and death from major hypertension-related cardiovascular diseases in the general population aged >=20 years?

P
Population
Individuals aged >=20 years in Canada between 1992 and 2003
I
Intervention
Increases in antihypertensive prescriptions (coinciding with the introduction of the Canadian Hypertension Education Program in 1999)
C
Comparator
Historical rates prior to 1999 (lower antihypertensive prescription rates)
O
Outcome
Standardized yearly mortality and hospitalization rates per 1000 for stroke, heart failure, and acute myocardial infarctionhard clinical

A national professional education program for hypertension management was associated with increased antihypertensive prescribing and significant reductions in cardiovascular mortality and hospitalizations.

Main Result

p-value: p=<0.001

Abstract

The Canadian Hypertension Education Program, an extensive professional education program to improve the management of hypertension, was started in 1999. There were very large increases in diagnosis and treatment of hypertension in the first 4 years after initiation of the program. The purpose of this study was to examine the association between the changes in antihypertensive therapy with changes in hospitalization and death from major hypertension-related cardiovascular diseases in Canada between 1992 and 2003. Using various national databases, Canadian standardized yearly mortality and hospitalization rates per 1000 for stroke, heart failure, and acute myocardial infarction were calculated for individuals aged >or=20 years and regressed against antihypertensive prescription rates. Changes in rates were examined in a time series analysis. There were significant reductions (P<0.0001) in the rate of death from stroke, heart failure, and myocardial infarction starting in 1999. There was also a reduction in hospitalization rate from stroke (P<0.0001) and heart failure (P<0.0001) but not myocardial infarction in 1999. The changes in death (P<0.001 for all 3 diseases) and hospitalization (P<0.0001 for stroke and heart failure; P=0.018 for acute myocardial infarction) were associated with the increases in antihypertensive prescriptions. This study demonstrates that the reduction in cardiovascular death and hospitalization rates is associated with an increase in antihypertensive prescriptions and that it coincides with the introduction of the Canadian Hypertension Education Program. The Canadian Hypertension Education Program educational model for improving health care could be adopted by other countries with well-developed professional and scientific societies.

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Cite This Study

Campbell et al. (2008) conducted an observational in Hypertension. Canadian Hypertension Education Program / Antihypertensive prescriptions was evaluated on Yearly mortality and hospitalization rates per 1000 for stroke, heart failure, and acute myocardial infarction (p=<0.001). Increases in antihypertensive prescriptions were associated with significant reductions in death from stroke, heart failure, and myocardial infarction (P<0.001 for all 3 diseases).

synapsesocial.com/papers/6a12c7a8b761793c20c08ad8https://doi.org/10.1161/hypertensionaha.108.119784
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