Department of Pharmacology and Clinical Pharmacy, Padjadjaran University, Bandung, Indonesia.
Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom.
PLoS One. 2024 Jul 24;19(7):e0307237. doi: 10.1371/journal.pone.0307237. eCollection 2024.
Adverse drug reactions (ADRs) represent a significant barrier to achieve optimal treatment outcomes. Cardiovascular drugs, including antihypertensive drugs, lipid-lowering drugs, and antithrombotic drugs, are among the most prescribed medications in the primary care setting.
To estimate the prevalence of cardiovascular drug-related ADRs consultations in United Kingdom (UK) primary care and identify risk factors of these ADRs.
This was a cross-sectional study of cardiovascular drug users between 2000-2019 using UK IQVIA Medical Research Data. ADRs consultations were identified using database screening method employing standardised designated codes. The overall and annual age-standardised prevalence was estimated using direct standardisation method using 2019 mid-year UK population. Risk factors of ADRs consultations were estimated using logistic regression model stratified by therapeutic areas.
The standardised prevalence of consultations related to cardiovascular drugs ADRs was 10.60 (95% CI. 10.46, 10.75) per 1000 patients. Patients aged 70-79 years had the highest occurrence of ADRs consultations. The most frequently drug classes implicated in the ADRs consultations were statins (n = 9,993 events, 27.09%), beta-blockers (n = 8,538 events, 23.15%), ACEIs/ARBs (n = 8,345 events, 22.62%), and aspirin (n = 6,482 events, 17.57%). Risk factors of ADRs consultations were previous history of cardiovascular diseases, e.g., myocardial infarction and stroke; advanced age, comorbidities; diabetes and dyslipidaemia; and polypharmacy.
The burden of cardiovascular drug-related ADRs consultations in primary care was considerable. Statins, beta-blockers, ACEIs/ARBs, and aspirin were the most frequently implicated drug classes. Closer clinical monitoring should be performed for patients affected by the ADRs to mitigate the risk of suboptimal treatment outcomes.
药物不良反应（ADR）是影响治疗效果的重要因素。心血管药物包括降压药、降脂药和抗血栓药，是初级保健中最常开的药物之一。
估计英国（UK）初级保健中心心血管药物相关 ADR 咨询的发生率，并确定这些 ADR 的危险因素。
这是一项 2000-2019 年期间使用英国 IQVIA 医疗研究数据的心血管药物使用者的横断面研究。使用数据库筛查方法，采用标准化指定代码识别 ADR 咨询。使用 2019 年年中英国人口进行直接标准化法估算总体和年度年龄标准化发生率。采用逻辑回归模型，按治疗领域分层，估计 ADR 咨询的危险因素。
心血管药物 ADR 咨询的标准化发生率为每 1000 名患者 10.60（95%CI，10.46，10.75）。70-79 岁的患者 ADR 咨询发生率最高。最常涉及 ADR 咨询的药物类别是他汀类（n = 9993 例事件，27.09%）、β受体阻滞剂（n = 8538 例事件，23.15%）、ACEI/ARB（n = 8345 例事件，22.62%）和阿司匹林（n = 6482 例事件，17.57%）。ADR 咨询的危险因素包括既往心血管疾病史，如心肌梗死和中风；高龄、合并症；糖尿病和血脂异常；以及多药治疗。
初级保健中心心血管药物相关 ADR 咨询的负担相当大。他汀类、β受体阻滞剂、ACEI/ARB 和阿司匹林是最常涉及的药物类别。应对受 ADR 影响的患者进行更密切的临床监测，以降低治疗效果不佳的风险。
