Comprehensive information on all prescribed blood pressure lowering drugs purchased in Finland during three months (September, October and November) in 2000, 2006, and 2011 was gathered from the database of the Social Insurance Institution of Finland. Beta-blockers, diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were defined as antihypertensive drugs. Only those individuals who were entitled to use reimbursed medication for either coronary heart disease or diabetes or both were included in the study. Individuals with moderate or severe hypertension were defined according to the criteria of the Social Insurance Institution of Finland.

Results

The number of individuals with coronary heart disease increased in the 11-year period examined by 3 percent, and the number of individuals with diabetes by 74 percent. The percentage of individuals with coronary heart disease using antihypertensive medication increased from 74 percent to 80 percent, and the percentage of individuals with diabetes from 56 percent to 71 percent. Forty-one percent of the individuals with coronary heart disease using antihypertensive medication, and 62 percent of the individuals with diabetes using antihypertensive medication were moderately to severely hypertensive in the year 2011. Twelve percent of the individuals with diabetes and 13 percent of individuals with coronary heart disease who were moderately to severely hypertensive were not using antihypertensive medication at least on a regular basis. The mean number of antihypertensive drugs per patient, i.e. use of combination therapy, increased during the 11-year period by 0.3. Beta-blockers were the most used of all antihypertensive drugs among both individuals with coronary heart disease and individuals with diabetes.

Conclusions

The management of hypertension in individuals with coronary heart disease and diabetes by using antihypertensive drug therapy increased and became more efficient during the 11-year period studied. Antihypertensive drug therapy in individuals with coronary heart disease was mainly in accordance with the recommendations of the current evidence-based hypertension guidelines. In individuals with diabetes antihypertensive drug therapy should be focused more on combination drug therapy based on calcium-channel blockers, diuretics, and agents acting on the renin-angiotensin system, instead of on beta-blockers.