Cardiovascular therapy in people with diabetes outside West Europe and North America: evidence from multiple clinical sites — ASN Events
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Cardiovascular therapy in people with diabetes outside West Europe and North America: evidence from multiple clinical sites (#309)

Stephanie Tanamas 1 , Jencia Wong 2 , Filip Surmont 3 , Ayesha A Motala 4 , Hiroshi Maegawa 5 , Andrea Luk 6 , Juan Jose Gagliardino 7 , Chern-En Chiang 8 , Silver Bahendeka 9 , Jonathan Shaw 1
  1. Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia
  2. Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia
  3. AstraZeneca, Shanghai, China
  4. Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
  5. Shiga University of Medical Science, Shiga, Japan
  6. Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong SAR, China
  7. Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET), La Plata, Argentina
  8. General Clinical Research Center, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
  9. San Raphael of St. Francis Nsambya Hospital, Kampala, Uganda

Aims

To characterize the prescription profile of cardiovascular drugs used to treat people with diabetes outside of West Europe and North America between 2006 and 2012.

 

Methods

Data from eleven clinical services (from Argentina, Australia, Hong Kong, India, Japan, Saudi Arabia, Uganda)  and two national registries (Russia, Taiwan) (n of patients per site: range 278 - 1737000) that have used electronic medical records to manage people with diabetes for several years were collected and pooled for statistical analysis. Each site summarized data extracted from out-patient medical records for 2006 and 2012 related to: demographics; disease history; diabetic complications; percentages on various classes of GLM as monotherapy, combined therapy or insulin, blood pressure- and lipid-lowering drugs; and mean laboratory values related to glycaemic and lipid levels as well as renal function.

Results

In all sites between 2006 and 2012, the percentage of patients on statins increased (range 19% to 139%), while mean low-density lipoprotein cholesterol decreased (range -0.003 to -0.3 mmol/l). Use of angiotensin-receptor blockers increased in all sites (range 16 to 143%) while the percentage on angiotensin-converting enzyme inhibitors decreased in most sites (range -51 to -9%) except for Hong Kong and Uganda (+12% and +4167%, respectively). Use of antihypertensive medication increased (range 3 to 27%) except in Australia and Uganda (-24% and -3%, respectively), but variable change in systolic blood pressure was observed. Anti-platelet use varied by site, but in some remained up to three times higher than the prevalence of major adverse cardiac events.

 

Conclusion

The use of cardiovascular medications in people with diabetes generally increased between 2006 and 2012. Such increase was not clearly accompanied by comparable improvement in lipid profile and blood pressure, thus suggesting that either drug dosage or patient adherence were not the most appropriate. There also appears to be large use of anti-platelet therapy for primary prevention of cardiovascular disease.

 

Disclosure statement

This study was supported by Astra Zeneca.