Facilitated Prescription of Antihypertensive Drugs and Decreased Premature Death from Stroke

pp. 120-125

Abstract

Background: Since 2003, the Remediar (+Redes) program supplies free antihypertensive medication. During this period, mortality from stroke has decreased, albeit with inequalities between socioeconomic groups.

Objective: The aim of this study was to assess the association between stroke mortality and the provision of antihypertensive drugs and to study the possible interaction between antihypertensive drug effects on mortality and socioeconomic status.

Methods: An ecological panel data study was performed. Mortality was expressed as standardized rates. Antihypertensive drugs were adjusted to the population among which they were provided and expressed in dispensing quartiles. Socioeconomic status was measured by unmet basic needs.

Results: Since the program initiation in 2003, the distribution of antihypertensive drugs increased significantly, especially in the less affluent groups (p<0.001). There was no statistically significant association between the dispensing rate of antihy pertensive drugs and overall stroke mortality. However, the interaction analyses showed that quintiles 3 to 5 of unmet basic needs (less affluent), the quartiles in which more antihypertensive drugs were distributed, had significantly lower mortality from stroke (p=0.004, p=0.015 and p=0.017, for socioeconomic status quartiles 3 to 5).

Conclusions: The results of this analysis indicate no antihypertensive drug dispensing overall effect on stroke mortality. However, the data suggest that among the most deprived groups, the distribution of antihypertensive drugs was associated with reduced mortality from this cause.