Nationwide trends in the prescription of beta-blockers and angiotensin-converting enzyme inhibitors after myocardial infarction in Denmark, 1995-2002.
OBJECTIVE
To study the use of beta-blockers and angiotensin-converting enzyme (ACE) inhibitors after acute myocardial infarction (AMI) in Denmark from 1995 to 2002.


METHODS
Information about patients with first AMI aged > or = 30 years and the dispensing of beta-blockers and ACE inhibitors from pharmacies within 30 d from discharge was obtained from the National Patient Registry and the Danish Registry of Medicinal Product Statistics.


RESULTS
Beta-blocker use increased from 38.1% of patients in 1995 to 67.9% in 2002 (OR = 3.85, CI: 3.58-4.13). Women, elderly patients and patients taking loop-diuretics and antidiabetic drugs received beta-blockers less frequently, but patients taking loop-diuretics or antidiabetic drugs had the greatest increase. ACE inhibitor use increased from 24.5 to 35.5% (OR = 1.86, CI: 1.72-2.01). Women, patients aged < 60 years or > or = 80 years and patients not taking loop-diuretics received ACE inhibitors less frequently, but patients not taking loop-diuretics had the greatest increase.


CONCLUSIONS
Beta-blocker use increased markedly post-AMI from 1995 to 2002, whereas ACE inhibitor use increased modestly. The results suggested undertreatment of women, elderly patients and people with diabetes.
Gislason
Gunnar H
GH
Department of Cardiovascular Medicine, Bispebjerg University Hospital, Copenhagen, Denmark. gg@heart.dk
Abildstrom
Steen Z
SZ
Rasmussen
Jeppe N
JN
Rasmussen
Søren
S
Buch
Pernille
P
Gustafsson
Ida
I
Friberg
Jens
J
Gadsbøll
Niels
N
Køber
Lars
L
Stender
Steen
S
Madsen
Mette
M
Torp-Pedersen
Christian
C
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000367:Age Factors; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D016001:Confidence Intervals; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D003718:Denmark; D004363:Drug Utilization / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D016017:Odds Ratio; D010818:Practice Patterns, Physicians'; D011336:Probability; D012042:Registries; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D015996:Survival Rate
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors