English summary: THE PROPORTION OF DIABETIC PEOPLE USING CHOLESTEROL LOWERING AND ANTIHYPERTENSIVE MEDICATION HAS INCREASED IN FINLAND

Background

Previous Finnish studies have shown that coronary heart disease mortality especially is very high among diabetic people compared to the non-diabetic population. The present study examines primary and secondary prevention of cardiovascular disease among diabetic people. Changes in the use of cholesterol lowering and antihypertensive drugs in the period 1997-2007 were examined among diabetic people of various ages. These changes were explored among people with insulin-dependent and non-insulin-dependent diabetes and among diabetic people with and without coronary heart disease.

Methods

The total diabetes population between 1997 and 2007 was obtained from the FinDM II database, which includes persons with diabetes identified in different Finnish health registers. All diabetic people aged 35 or over were included in the analyses. The information from the registers was used to establish if the diabetic condition existed prior to each year of study. People in long-term institutional care were excluded from the analyses. Changes in the use of medication were scrutinised from 1997 to 2007. The statistical significance of the changes was analysed using Poisson regression models.

Results

According to our study data, there were 233 189 diabetic people aged 35 or over in Finland at the beginning of 2007. Compared with the beginning of 1997, the prevalence of diabetes had increased by 65%. Among insulin-dependent diabetic people 14% had coronary heart disease at the beginning of 2007. Among non-insulin-dependent diabetic people the corresponding figures were 26% for men and 21% for women. Cholesterol lowering drugs were used by 30% of diabetic people with coronary heart disease in 1997 compared with 80% in 2007. The corresponding figures for diabetic people with no diagnosed coronary heart disease were 9% and 48%, respectively. The antihypertensive drugs used most widely by diabetic people with coronary heart disease were β-blockers, with 88% of men and 86% of women using them in 2007. Among diabetic people with coronary heart disease the use of ACE inhibitors increased, especially among men, with 40% of men and 30% of women using ACE inhibitors in 2007. The use of a new class of antihypertensive drugs, angiotensin II receptor antagonists, became more common among both men and women, with about 20% of diabetic people with coronary heart disease using them in 2007.

Conclusion

The proportion of diabetic people using cholesterol lowering and antihypertensive drugs clearly increased between 1997 and 2007. Currently the use of cholesterol lowering drugs seems to follow the treatment recommendations more closely than earlier. Almost all diabetic people with coronary heart disease used β-blockers in 2007.

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