Initial cardiovascular treatment patterns during the first 90 days following an incident cardiovascular event

Area of Science:

• Cardiovascular medicine
• Pharmacology
• Public health

Background:

• Cardiovascular diseases (CVDs) like coronary heart disease (CHD) and stroke are leading causes of mortality and morbidity worldwide.
• Initial management following a cardiovascular event often involves multiple medications to address risk factors and prevent recurrence.
• Understanding initial prescription patterns is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To investigate initial cardiovascular drug prescription patterns in patients following their first cardiovascular event (CHD or stroke).
• To identify patient characteristics associated with cardiovascular polypharmacy (prescription of five or more cardiovascular drugs).

Main Methods:

• A cross-sectional study utilizing The Health Improvement Network (THIN) database.
• Inclusion of patients aged 45 years or older with a first record of CHD or stroke between 2007 and 2016.
• Logistic regression analysis to determine factors associated with cardiovascular polypharmacy within 90 days of the event.

Main Results:

• Over 121,000 patients were analyzed, with a mean age of 69.5 years.
• A significant proportion of patients (over 59%) were prescribed four or more cardiovascular drugs within 90 days of their first event.
• Factors associated with polypharmacy included younger age, current smoking, obesity, higher deprivation status, and greater comorbidity burden (Charlson Comorbidity Index ≥5). Female sex was associated with lower polypharmacy.

Conclusions:

• Cardiovascular polypharmacy is prevalent in patients after their first cardiovascular event in the UK.
• Specific patient factors are linked to higher rates of polypharmacy, suggesting potential areas for intervention.
• Further research is needed to evaluate the clinical impact and outcomes associated with cardiovascular polypharmacy in this population.