Out-patient antihypertensive drug utilization and stroke mortality: An ecological study

Abstract

Directly age-standardized rates of out-patient utilization of antihypertensive drugs (antihypertensives, diuretics and beta-blockers) and stroke mortality in men and women (40-79 years of age) were compared over 4 years (1987-1990) in a midwestern (Värmland) and a southern (Skåne) province of Sweden and in their 49 (16 + 33) municipalities. In both genders, the stroke mortality and utilization rates of the 3 antihypertensive drug groups, both combined and separate, were higher in Värmland and there were positive correlations between these rates when all 49 municipalities were compared. On the other hand, for each province and each drug group there were municipalities with every possible combination of stroke mortality and antihypertensive drug utilization rates. In addition, antihypertensive drug utilization rates were similar in men and women even though the stroke mortality rates were much lower among the latter. The findings cast doubt on the effectiveness of antihypertensive drug treatment in common practice.