Correlation of drug utilisation and morbidity at the municipality level. High use of antibiotics associated with low use of antihypertensives

Abstract

Objective: The aim of the study was to explore the relationship between Swedish drug sales data per municipality and morbidity per municipality. The morbidity was expressed as "sickness numbers" which are assumed to function as proxy for morbidity. Methods: Sickness numbers per municipality were correlated to volumes of drug sales per municipality in 2003. In addition, the sales volumes of antibiotics were correlated to the sales volumes of other drugs. Results: We found significant positive correlations between municipality sickness numbers and sales volumes for most drug groups, except for antibiotics where the correlations were negative in all age groups. When the volumes of antibiotics were related to the volumes of other drug groups it was observed that municipalities with volumes of antibiotics above the national average had reduced volumes of cardiovascular drugs, especially of diuretics, beta blockers and calcium antagonists, all primarily used as antihypertensives. For ACE inhibitors and statins, no such relationship was found. Conclusion: The findings might suggest a link between infection and hypertension, but a cause-effect relation is not established. © Springer-Verlag 2006.