Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2013;66:854-63 - Vol. 66 Num.11 DOI: 10.1016/j.rec.2013.05.027

Use of Drugs Related to the Treatment of Diabetes Mellitus and Other Cardiovascular Risk Factors in the Spanish Population. The Di@bet.es Study

Gemma Rojo-Martínez a,b, Sergio Valdés a,b, Natalia Colomo b, M. Isabel Lucena c, Sonia Gaztambide a,d, Ramón Gomis a,e, Roser Casamitjana a,f, Rafael Carmena a,g, Miguel Catalá a,g, María T. Martínez-Larrad a,h, Manuel Serrano-Ríos a,h, Luis Castaño a,d, Joan Vendrell a,i, Juan Girbés j, Josep Franch k, José A. Vázquez l, Inmaculada Mora-Peces m, Inés Urrutia a,d, Gemma Pascual-Manich a, Emilio Ortega a,n, Edelmiro Menéndez o, Elias Delgado o, Elena Bordiú p, Conxa Castell q, Alfonso López-Alba r, Alberto Goday s, Alfonso Calle t, Anna Bosch-Comas u, Federico Soriguer a,b,

a Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
b Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
c Departamento de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Facultad de Medicina, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
d Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
e Unidad de Endocrinología y Diabetes, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
f Centro de Diagnóstico Biomédico, Hospital Clínic, Barcelona, Spain
g Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
h Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
i Servicio de Endocrinología y Nutrición, Hospital Universitario Joan XXIII, Institut d’Investigacions Sanitàries Pere Virgili, Tarragona, Spain
j Unidad de Diabetes, Hospital Arnau de Vilanova, Valencia, Spain
k EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Atención Primaria, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol), Barcelona, Spain
l Plan Nacional de Diabetes, Ministerio de Sanidad, Madrid, Spain
m Sistema de Salud Canario, Tenerife, Spain
n Unidad de Endocrinología y Diabetes, Hospital Clínic, Barcelona, Spain
o Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
p Laboratorio de Endocrinología, Hospital Universitario San Carlos, Madrid, Spain
q Departament de Salut Pública, Conselleria de Sanitat, Generalitat de Catalunya, Barcelona, Spain
r Sociedad Española de Diabetes, Madrid, Spain
s Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
t Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos, Madrid, Spain
u Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

Keywords

Drug use. Diabetes mellitus. Hypertension. Hypercholesterolemia. Population-based study.

Abstract

Introduction and objectives

To assess the patterns of use of 8 therapeutic drug groups for the treatment of diabetes mellitus and other cardiovascular risk factors, and to identify sociodemographic and health determinants of their use in the overall Spanish population.

Methods

A representative sample of the Spanish population within the Di@bet.es study, a cross-sectional population-based survey, was included. Study variables: sociodemographic, clinical, and lifestyle data; physical examination, and an oral glucose tolerance test in patients without known diabetes mellitus. Furthermore, patients were systematically queried about current medication use, and 8 pharmacotherapeutic groups were evaluated: lipid-lowering therapy, antihypertensives, oral hypoglycemic agents, insulin, thyroid hormone, uricosurics, psychoactive drugs, and nonsteroidal anti-inflammatory drugs.

Results

Sixty-six percent of the Spanish population was taking at least one medication. Therapeutic drug use was associated with age, independently of the higher prevalence of diabetes mellitus, hypertension, or hyperlipidemia in older patients. Sex disparities were found in the use of lipid-lowering agents, allopurinol, levothyroxine, nonsteroidal anti-inflammatory drugs, and psychoactive drugs. Use of psychoactive drugs was related to education level, work status, physical activity, smoking, and alcohol consumption. Almost 30% of patients with diabetes mellitus were taking 6 or more medications daily. Diabetes mellitus was associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs.

Conclusions

Age and sex are the most important factors determining therapeutic drug use. Lifestyle patterns and sociocultural factors have an impact only on psychoactive drug use. Diabetes mellitus is associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs.

1885-5857/© 2013 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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