Antihypertensive drug use tripled (144.57 to 439.13 DDD/1,000/day) and lipid-lowering agent use increased over 30-fold (4.91 to 152.56 DDD/1,000/day) in Croatia between 2000 and 2024.
Observational
How has the utilization of antihypertensive and lipid-lowering therapies changed in Croatia over the past two decades?
Pharmacological management of cardiovascular risk in Croatia has expanded markedly over the past two decades, though gaps remain between clinical evidence and real-world utilization.
Objective: Cardiovascular diseases remain the leading cause of morbidity and mortality globally, with hypertension and dyslipidemia as major modifiable risk factors. This study aimed to evaluate national trends in the utilization of antihypertensive drugs and lipid-lowering agents in Croatia over the past two decades, providing a comprehensive picture of pharmacological cardiovascular risk management. Design and method: Population-based observational analyses were conducted using national IMS and IQVIA pharmaceutical databases. Drug utilization was quantified as defined daily doses per 1,000 inhabitants per day (DDD/1,000/day). Trends in prescribing patterns, class shifts, and financial expenditures by therapeutic groups and by individual agents were assessed for lipid-lowering agents (2000–2023) and antihypertensive agents (2000–2024). Results: Antihypertensive drug use tripled over 25 years, rising from 144.57 to 439.13 DDD/1,000/day. Agents targeting the renin–angiotensin system and fixed-dose combinations predominating, although prescribing patterns did not fully align with evolving guideline recommendations. Lipid-lowering agent utilization increased more than 30-fold, from 4.91 DDD/1,000/day in 2000 to 152.56 DDD/1,000/day in 2023, primarily driven by statins such as atorvastatin and rosuvastatin, with gradual uptake of newer therapies like PCSK9 inhibitors and ezetimibe. Across all therapeutic areas, average drug prices per DDD declined, improving access but not fully overcoming clinical inertia. Conclusions: Pharmacological management of cardiovascular risk in Croatia has expanded markedly over the past two decades, reflecting therapeutic advances and broader treatment access. However, significant gaps remain between clinical evidence, guideline adherence, and real-world utilization. Addressing administrative and reimbursement obstacles alongside enhanced clinician and patient engagement is essential to optimize cardiovascular outcomes nationally.
Belancic et al. (Fri,) conducted a observational in Hypertension and dyslipidemia. Antihypertensive and lipid-lowering therapies was evaluated on Drug utilization (DDD/1,000/day). Antihypertensive drug use tripled (144.57 to 439.13 DDD/1,000/day) and lipid-lowering agent use increased over 30-fold (4.91 to 152.56 DDD/1,000/day) in Croatia between 2000 and 2024.