Antihypertensive medication prescribing in 27,822 elderly Canadians with diabetes over the past decade

Diabetes Care. 2006 Apr;29(4):836-41. doi: 10.2337/diacare.29.04.06.dc05-1875.

Abstract

Objective: The purpose of this study was to examine whether prescribing practices for elderly individuals with diabetes and hypertension changed over the past decade.

Research design and methods: We linked the Ontario Diabetes Database and four administrative databases in Ontario, Canada, to identify 27,822 patients >65 years of age who had diabetes and were newly treated for hypertension between 1 January 1995 and 31 December 2001. All patients were followed for 2 years after their initial antihypertensive medication prescription.

Results: The 27,822 patients in this study (mean age 72 years, 51% men) were treated with oral hypoglycemic agents alone (n = 17,128 patients, 62%), insulin alone (n = 2,346, 8%), both oral hypoglycemic agents and insulin (n = 2,205, 8%), or diet alone (n = 6,143, 22%). Management within the first 2 years of hypertension diagnosis consisted of antihypertensive monotherapy in 20,183 patients (73%), two antihypertensive drugs in 6,207 (22%), and three or more drugs in 1,432 (5%); the most frequently chosen antihypertensive drugs were ACE inhibitors (68%), thiazides (15%), and calcium channel blockers (9%). Between 1995 and 2001, physician prescribing practices changed: the population-adjusted rates of antihypertensive drug prescribing increased by 46% (95% CI 33-55%), the proportion of initial antihypertensive prescriptions for ACE inhibitors increased from 54 to 76% (P < 0.0001), and the use of multiple antihypertensive agents within the first 2 years of diagnosis increased from 21 to 32% (P < 0.0001).

Conclusions: Antihypertensive prescribing patterns in elderly individuals with diabetes changed over the past decade in Ontario in directions consistent with the evolving evidence base.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antihypertensive Agents / therapeutic use*
  • Canada
  • Comorbidity
  • Diabetes Mellitus / drug therapy*
  • Drug Therapy, Combination
  • Drug Utilization / statistics & numerical data
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Practice Patterns, Physicians' / statistics & numerical data
  • Practice Patterns, Physicians' / trends*
  • Retrospective Studies

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents