title: [Pharmacotherapy of arterial hypertension and pharmacoeconomic aspects of hypotensive therapy in elderly patients in Poland].
abstract: The aim of our study was to examine the use of pharmacological therapy and to evaluate the economical aspects of treating hypertension (HT) in elderly patients in Poland. Two hundred and sixty eight elderly persons (147 females, 121 males; mean age: 72.2 +/- 6.0 years) were selected from Polish population by stratified and cluster random sampling with quotas. BP measurement was performed 3 times every 2 minutes at respondents home. In the questionnaire, awareness of HT was assessed. Prevalence of hypertension among subjects aged 65 years and over by JNC VI criteria (SAP > or = 140 mm Hg, DAP > or = 90 mm Hg or hypotensive therapy) was 74%. Awareness of HT was equal to 61%. Eleven percent of all hypertensives were well controlled. Among hypertensives, 71% took prescribed antihypertensive drugs on a regular basis. Patients with HT were taking the following antihypertensive drugs: diuretics 16%, diuretics and reserpine 20%, beta-blockers 19%, ACE inhibitors 53%, calcium antagonists 30%, and other 3%. Newer drugs were prescribed in 7%, and multi-source (generic) products in 93%. The average cost of treatment with one drug was 147 PLN (37.5 USD) per year (newer drugs: 413 PLN; multi-source product 126 PLN). Assuming those data and number of elderly people in Poland (4.335 mln), we estimated that 3.208 mln of subjects have had hypertension according to JNC VI criteria. Only 1.957 mln of patients with HT have been detected and only 0.353 mln of hypertensives have been well controlled. The approximate global cost of antihypertensive drugs per year in elderly patients in Poland has been equal to 285 mln PLN (72.8 mln USD). In hypothetical situation with optimal (100%) detection and control of HT the global cost by the actual rate of regularity in taking drugs would increase to 569 mln PLN (145.3 mln USD). The prevalence of HT in elderly people in Poland is very high. In elderly hypertensives ACE inhibitors are used most often. More than 90% of prescribed drugs are multi-source products. An optimal improvement of HT detection and control would cause a two-fold augmentation of the costs of pharmacological therapy.
authors.affiliation: Katedra i Klinika Nadciśnienia Tetniczego i Diabetologii Akademii Medycznej w Gdańsku.
authors.forename: T
authors.initials: T
authors.lastname: Zdrojewski
authors.forename: W
authors.initials: W
authors.lastname: Januszko
authors.forename: W
authors.initials: W
authors.lastname: Drygas
authors.forename: W
authors.initials: W
authors.lastname: Zebrowska
authors.forename: W
authors.initials: W
authors.lastname: Kuźmierkiewicz
authors.forename: B
authors.initials: B
authors.lastname: Wyrzykowski
authors.forename: B
authors.initials: B
authors.lastname: Krupa-Wojciechowska
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D017850:Economics, Pharmaceutical; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D007022:Hypotension / Q000188:drug therapy* / Q000191:economics*; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence
chemical_list: D000959:Antihypertensive Agents