A major new international study involving researchers from the Sahlgrenska Academy at the University of Gothenburg and Sahlgrenska University Hospital has revealed that aspirin, statins, beta blockers and ACE inhibitors are prescribed far too infrequently. They are cheap, preventive medicines that could prevent a huge number of deaths from heart attacks and strokes.
The result of a research collaboration between 17 countries, the study is being published in the highly revered medical journal The Lancet.
The study identifies aspirin, statins (cholesterol-lowering medication), beta blockers and ACE inhibitors as medicines that should be used far more widely.
"These are generic preparations where the patent has run out," says Annika Rosengren, professor of medicine at the Sahlgrenska Academy at the University of Gothenburg and consultant at Sahlgrenska University Hospital. "They are cheap, tried-and-tested and effective, and there is no good reason for failing to prescribe them far more often to patients who are in the risk zone. In Sweden alone they could have saved thousands of lives a year."
The results derive from a major international study involving more than 150,000 adults in low-, middle- and high-income countries around the world. Just a quarter of those who had suffered a heart attack or stroke had taken aspirin (or similar), only a fifth had taken beta blockers, and just a seventh had taken medication to lower their cholesterol. The lowest figures came from low-income countries. The study also shows that women take these medicines less frequently than men.
"The results indicate a real need for a systematic drive to understand why such cheap drugs are under-used the world over," says professor Salim Yusuf at McMaster University in Canada, who headed up the study. "This is a global tragedy and represents a massive lost opportunity to help millions of people with cardiovascular disease at a very low cost."
The PURE study (Prospective Urban Rural Epidemiology Study) covered 17 countries: Canada, Sweden, United Arab Emirates, Argentina, Brazil, Chile, Malaysia, Poland, South Africa, Turkey, China, Colombia, Iran, Bangladesh, India, Pakistan and Zimbabwe.
- Salim Yusuf, Shofiqul Islam, Clara K Chow, Sumathy Rangarajan, Gilles Dagenais, Rafael Diaz, Rajeev Gupta, Roya Kelishadi, Romaina Iqbal, Alvaro Avezum, Annamarie Kruger, Raman Kutty, Fernando Lanas, Liu Lisheng, Li Wei, Patricio Lopez-Jaramillo, Aytekin Oguz, Omar Rahman, Hany Swidan, Khalid Yusoff, Witold Zatonski, Annika Rosengren, Koon K Teo. Use of secondary prevention drugs for cardiovascular disease in the community in high-income, middle-income, and low-income countries (the PURE Study): a prospective epidemiological survey. The Lancet, 2011; DOI: 10.1016/S0140-6736(11)61215-4
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