Factors associated with differences in antihypertensive drug treatment: results from the MONICA Augsburg Population Surveys 1989/90 and 1994/95.
OBJECTIVE
To investigate in a population-based sample of hypertensive men and women the impact of factors that determine frequency and pattern of antihypertensive treatment.


METHODS
We used pooled data of two independent surveys conducted 1989/90 and 1994/95 in the Augsburg region among men and women aged 25 to 74 years. Co-morbidity and cardiovascular risk factors were assessed by questionnaire and examination. Multivariate and polytomous logistic regression analyses were used to assess treatment patterns adjusting for cofactors.


RESULTS
Among a total of 9,795 survey participants, 2,279 men and 1,699 women were hypertensive with 30% of men and 43% of women using antihypertensive drugs. Hypercholesterolemia was unrelated and smoking even inversely related to treatment (adjusted odds ratio OR = 0.7, 95% CI 0.56-0.92). Women were more likely to be treated than men (adjusted OR = 1.6, 95% CI: 1.34-1.82). Furthermore, women on monotherapy used diuretics significantly more often than men (adjusted OR relative to betablocker use 2.8, 95% CI: 1.6-4.8).


CONCLUSIONS
We identified several determinants of drug treatment among hypertensives in the community. During the study period antihypertensive treatment seemed to be determined primarily by clinical disease but not by concomitant cardiovascular risk factor status, such as male gender, smoking, or hypercholesterolemia.
Institute of Epidemiology and Social Medicine, University of Münster. Christiane_gasse@med.uni-heidelberg.de
Christiane
C
Gasse
Hans-Werner
HW
Hense
Jutta
J
Stieber
Angela
A
Döring
Angela D
AD
Liese
Günther
G
Heller
Ulrich
U
Keil
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004232:Diuretics / Q000627:therapeutic use; D004363:Drug Utilization; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D004232:Diuretics