[Use of antihypertensive agents in Cantabria, Spain [1995-2002]: discrepancy with the published evidence]

To ascertain the pattern of prescription of antihypertensive drugs in Cantabria and its variation from published evidence between 1995 and 2002.

We reviewed the database of the pharmaceutical data processing system of the Cantabrian Health Service on the consumption and cost of the drugs indicated in the treatment of hypertension. Consumption data is expressed in defined daily doses per thousand inhabitants and day (DID).

Consumption of antihypertensive agents was 130.2 DID in 1995 and was 235 DID in 2002. The contribution of diuretics to overall consumption fell from 34.3% in 1995 to 25.8% in 2002, and that of beta-blockers fell from 6.5% in 1995 to 5.9% in 2002. The most commonly used group in all years was angiotensin converting-enzyme inhibitors, which represented 36.8% of consumption in 2002. Angiotensin-II antagonists showed the biggest rise, accounting for 13.2% of prescriptions in 2002 and for 26% of expenditure on antihypertensive agents. The pattern of use of the drugs utilized in the major published trials during this period showed no change or even fell, except in the case of enalapril.

The present study confirms that the prescription antihypertensive drugs has considerably increased and that the consumption pattern of these drugs has changed. The discrepancy between these findings and those of the major trials could have significant economic implications.