Oreberg M, Jonsson G G, West K, Eberhard-Grahn M, Råstam L, Melander A
Health Care Centre, Hörby, Sweden.
Eur J Clin Pharmacol. 1992;43(5):449-54. doi: 10.1007/BF02285084.
A comparison of cardiovascular drug sales and cardiovascular mortality was made between two Swedish counties (Värmland and Malmöhus) and between two rural municipalities in those counties (Torsby in Värmland and Hörby in Malmöhus). Cardiovascular drug sales (defined daily doses (DDD) per 1,000 inhabitants per day) during 1986-87 were 25% higher in Värmland than in Malmöhus county, and the age-standardized mortality of coronary heart disease (CHD) was 36% (men) and 54% (women) higher. In Torsby, age-standardized CHD mortality (1986-87) was 71% (both sexes) higher than in Hörby, and the sales of cardiovascular drugs (1978-87) were 58% higher. Statistically, every third inhabitant of Torsby took one DDD of a cardiovascular drug every day, as compared to every fifth inhabitant in Hörby. In Torsby there was a 6% higher serum cholesterol, 71% lower tap water hardness, 33% lower income, a lower educational level, a three-fold higher unemployment rate, and a different ethnic background (20% eastern Finnish ancestry), all factors assumed to promote a high CHD rate. All of these factors may contribute to the higher CHD mortality, which was in turn reflected in higher sales of cardiovascular drugs.
对瑞典的两个郡（韦姆兰和马尔默胡斯）以及这两个郡内的两个农村自治市（韦姆兰的托尔斯比和马尔默胡斯的赫尔比）的心血管药物销售额与心血管疾病死亡率进行了比较。1986 - 1987年期间，韦姆兰的心血管药物销售额（每千居民每日限定日剂量（DDD））比马尔默胡斯郡高25%，冠心病（CHD）的年龄标准化死亡率男性高36%，女性高54%。在托尔斯比，年龄标准化的冠心病死亡率（1986 - 1987年）比赫尔比高71%，心血管药物销售额（1978 - 1987年）高58%。从统计学角度看，托尔斯比每三名居民中就有一人每天服用一剂心血管药物，而在赫尔比这一比例是每五名居民中有一人。在托尔斯比，血清胆固醇水平高6%，自来水硬度低71%，收入低33%，教育水平低，失业率高三倍，且有不同的种族背景（20%有芬兰东部血统），所有这些因素都被认为会促使冠心病发病率升高。所有这些因素可能都导致了较高的冠心病死亡率，而这反过来又反映在心血管药物的较高销售额上。
