Cardiovascular medication changes over 5 years in a national data linkage study: implications for risk prediction...

Area of Science:

• Cardiovascular Medicine
• Public Health
• Pharmacotherapy Research

Background:

• Cardiovascular disease (CVD) risk prediction models often overlook baseline pharmacotherapy and treatment changes.
• This oversight may lead to underestimation of true CVD event risk.
• Understanding medication use patterns is crucial for accurate risk assessment.

Purpose of the Study:

• To examine changes in CVD pharmacotherapy over five years.
• To inform the development of new 5-year CVD risk prediction models.
• To assess the impact of baseline and changing pharmacotherapy on CVD risk.

Main Methods:

• Utilized anonymized linkage of eight national health datasets in New Zealand.
• Identified individuals aged 30-74 without prior CVD or heart failure in 2006.
• Determined baseline and longitudinal (2007-2011) dispensing of blood pressure, lipid-lowering, and antiplatelet/anticoagulant medications.

Main Results:

• The study included 1,766,584 individuals, representing 85% of the target population.
• 21% of participants received baseline CVD medications, with most continuing for over 80% of follow-up.
• Medication changes were modest: 2% discontinuation, 7% new prescriptions during follow-up.

Conclusions:

• Baseline CVD pharmacotherapy was used by one in five individuals in this primary prevention cohort.
• Medication changes over five years were generally modest.
• Baseline medication use significantly impacts CVD risk models, though incorporating treatment changes requires further investigation, especially for 10-year risk models.