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BMJ Open. 2019 Apr 14;9(4):e023571. doi: 10.1136/bmjopen-2018-023571.

Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker' health study (Spain).

Author information

Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain.
Grupo de Investigación en Servicios Sanitarios de Aragón (GRISSA), Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.
Primary Health Care, Aragon Health Service, Zaragoza, Spain.
Biocomputing Unit. Health Services and Policy Research Group (ARiHSP), Institute of Health Sciences in Aragon (IACS), Zaragoza, Spain.
Unidad de Investigación en Prevención Cardiovascular, Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.



To identify cardiovascular disease (CVD) preventive treatments combinations, among them and with other drugs, and to determine their prevalence in a cohort of Spanish workers.


Cross-sectional study.


Aragon Workers' Health Study (AWHS) cohort in Spain.


5577 workers belonging to AWHS cohort. From these subjects, we selected those that had, at least, three prescriptions of the same therapeutic subgroup in 2014 (n=4605).


Drug consumption was obtained from the Aragon Pharmaceutical Consumption Registry (Farmasalud). In order to know treatment utilisation, prevalence analyses were conducted. Frequent item set mining techniques were applied to identify drugs co-prescription patterns. All the results were stratified by sex and age.


42.3% of men and 18.8% of women in the cohort received, at least, three prescriptions of a CVD preventive treatment in 2014. The most prescribed CVD treatment were antihypertensives (men: 28.2%, women 9.2%). The most frequent association observed among CVD preventive treatment was agents acting on the renin-angiotensin system and lipid-lowering drugs (5.1% of treated subjects). Co-prescription increased with age, especially after 50 years old, both in frequency and number of associations, and was higher in men. Regarding the association between CVD preventive treatments and other drugs, the most frequent pattern observed was lipid-lowering drugs and drugs used for acid related disorders (4.2% of treated subjects).


There is an important number of co-prescription patterns that involve CVD preventive treatments. These patterns increase with age and are more frequent in men. Mining techniques are a useful tool to identify pharmacological patterns that are not evident in the individual clinical practice, in order to improve drug prescription appropriateness.


cardiovascular epidemiology; mining technique; pharmaco-prevention

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