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      Prevalence of cardiovascular drug-related adverse drug reactions consultations in UK primary care: A cross-sectional study

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      Author(s): 1 , 2 , 3 , 2 , 2 , 4 , * ,
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      Publication date (Electronic):
      Journal: PLOS ONE
      Publisher: Public Library of Science

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          Abstract

          Background

          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.

          Objectives

          To estimate the prevalence of cardiovascular drug-related ADRs consultations in United Kingdom (UK) primary care and identify risk factors of these ADRs.

          Methods

          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.

          Results

          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.

          Conclusions

          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.

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          Most cited references75

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          Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019

          Gregory A Roth, George A Mensah, Catherine O. Johnson … (2022)
          Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
          Article 0 comments Cited 3554 times – based on 0 reviews     Review now
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            A Randomized Trial of Intensive versus Standard Blood-Pressure Control

            Jackson T Wright, Jeff D. Williamson, Paul K. Whelton … (2015)
            New England Journal of Medicine, 373(22), 2103-2116
            Article 0 comments Cited 1089 times – based on 0 reviews     Review now
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              Prevalence, Incidence, and Mortality of Stroke in China: Results from a Nationwide Population-Based Survey of 480 687 Adults.

              Wenzhi Wang, Jing-Bin Jiang, Haixin Sun … (2017)
              China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the past 30 years.
              Article 0 comments Cited 728 times – based on 0 reviews     Review now
              Article has an altmetric score of 79
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                Author and article information

                Contributors
                Widya N. Insani:
                ORCID: https://orcid.org/0000-0002-0066-9746
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Writing – original draft
                Cate Whittlesea:
                ORCID: https://orcid.org/0000-0002-4951-2272
                Role: ConceptualizationRole: SupervisionRole: Writing – review & editing
                Li Wei: Role: ConceptualizationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Hean Teik Ong: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS One
                Journal ID (publisher-id): plos
                Title: PLOS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 24 July 2024
                Publication date Collection: 2024
                Volume: 19
                Issue: 7
                Electronic Location Identifier: e0307237
                Affiliations
                [1 ] Department of Pharmacology and Clinical Pharmacy, Padjadjaran University, Bandung, Indonesia
                [2 ] Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
                [3 ] Centre of Excellence for Pharmaceutical Care Innovation, Padjadjaran University, Bandung, Indonesia
                [4 ] Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, United Kingdom
                HT Ong Heart Clinic, MALAYSIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-0066-9746
                https://orcid.org/0000-0002-4951-2272
                Article
                Publisher ID: PONE-D-24-17876
                DOI: 10.1371/journal.pone.0307237
                PMC ID: 11268649
                PubMed ID: 39046945
                SO-VID: 92f37344-4d3b-45c5-8b83-06ca0944c4e7
                Copyright © © 2024 Insani et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 15 May 2024
                Date accepted : 28 June 2024
                Page count
                Figures: 2, Tables: 3, Pages: 14
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100014538, Lembaga Pengelola Dana Pendidikan;
                Award ID: 201908223215121
                Award Recipient :
                ORCID: https://orcid.org/0000-0002-0066-9746
                WNI is funded by a scholarship from Indonesia Endowment Fund for Education (LPDP No. 201908223215121). This funding body had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Pharmacology
                Subject: Adverse Reactions
                Subject: Medicine and Health Sciences
                Subject: Pharmacology
                Subject: Drugs
                Subject: Antihypertensive Drugs
                Subject: Medicine and Health Sciences
                Subject: Health Care
                Subject: Primary Care
                Subject: Medicine and Health Sciences
                Subject: Cardiology
                Subject: Medicine and Health Sciences
                Subject: Medical Conditions
                Subject: Cardiovascular Diseases
                Subject: Medicine and Health Sciences
                Subject: Cardiology
                Subject: Cardiovascular Medicine
                Subject: Cardiovascular Diseases
                Subject: Medicine and Health Sciences
                Subject: Pharmaceutics
                Subject: Drug Therapy
                Subject: Cardiovascular Therapy
                Subject: Medicine and Health Sciences
                Subject: Medical Conditions
                Subject: Cardiovascular Diseases
                Subject: Cardiovascular Disease Risk
                Subject: Medicine and Health Sciences
                Subject: Cardiology
                Subject: Cardiovascular Medicine
                Subject: Cardiovascular Diseases
                Subject: Cardiovascular Disease Risk
                Subject: Medicine and Health Sciences
                Subject: Pharmacology
                Subject: Drugs
                Subject: Statins
                Custom metadata
                Data Availability De-identified patients data underlying the results presented in the study are available from UK IQVIA Medical Research Data, which incorporates data from THIN, a Cegedim Database. Reference made to THIN is intended to be descriptive of the data asset licensed by IQVIA (Reference number:21SRC008. Contact: IMRDEnquiries@ 123456iqvia.com ).

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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