Mond Lieselotte, Geyer Siegfried, Tetzlaff Juliane, Weißenborn Karin, Schneider Johanna, Epping Jelena
Medical Sociology Unit, Hannover Medical School, Hanover, Germany.
Department of Neurology, Hannover Medical School, Hanover, Germany.
Pharmacoepidemiol Drug Saf. 2025 Jan;34(1):e70077. doi: 10.1002/pds.70077.
Successful prevention of cardiovascular diseases (CVD) may reduce the burden of diseases. Preventive medication is an important measure to decrease the risks of cardiovascular events, in particular myocardial infarction and stroke. The aim of this study is to analyze the prevalence of CVD preventive medication in Germany over time with respect to sex and age and to compare it with the temporal development of strokes.
The study is based on statutory health insurance claims data from the AOK Niedersachsen (AOKN) covering the years 2005-2018. The study population comprises all AOKN insured persons aged 18 years and older (N = 2 088 495). Age-standardized time trends of the prevalence of CVD preventive medication and incidence of stroke were calculated for men and women in different age groups. After that, the relationship of both measures was examined in an ecological correlation.
We found a clear increase in medication prevalence over time. In 2018, about 35% of the total population and about 85% of those over 85 years of age received CVD preventive medication. At the same time, age-standardized incidence rates of ischemic stroke were decreasing slightly. The ecological correlation showed a negative association between medication prevalence and stroke incidence especially in the higher age groups.
High correlation coefficients indicate that higher medication prevalence could be linked to better population health. Further research is needed to draw conclusions about the effects of increasing medicalization, including adverse risks and side effects at the population level.
成功预防心血管疾病（CVD）可能会减轻疾病负担。预防性用药是降低心血管事件风险，特别是心肌梗死和中风风险的重要措施。本研究的目的是分析德国心血管疾病预防性用药随时间推移在性别和年龄方面的流行情况，并将其与中风的时间发展情况进行比较。
该研究基于下萨克森州AOK（AOKN）2005 - 2018年的法定医疗保险理赔数据。研究人群包括所有18岁及以上的AOKN参保人员（N = 2088495）。计算了不同年龄组男性和女性心血管疾病预防性用药流行率和中风发病率的年龄标准化时间趋势。之后，在生态相关性分析中检验了这两种指标的关系。
我们发现用药流行率随时间明显增加。2018年，约35%的总人口和约85%的85岁以上人群接受了心血管疾病预防性用药。与此同时，缺血性中风的年龄标准化发病率略有下降。生态相关性分析表明，用药流行率与中风发病率之间呈负相关，尤其是在较高年龄组。
高相关系数表明较高的用药流行率可能与更好的人群健康状况相关。需要进一步研究以得出关于医疗化增加的影响的结论，包括人群层面的不良风险和副作用。
