Use of antihypertensive drugs in the Italian hospitals

Calcium channel blockers and ACE-inhibitors are among the most common drugs prescribed for the initial treatment of hypertension. While their ability to control surrogate outcomes, such as blood pressure and left ventricular hypertrophy, is proven, there is limited evidence of their prevention of ma jor cardiovascular events, including mortality. The aim of our work was to assess the use of these drugs in Italy in comparison with beta-blockers and diuretics. We examined the consumption of the four main antihypertensive c lasses of drugs (beta-blockers, diuretics, calcium channel blockers and ACE -inhibitors). In-hospitalization data from the GIFA (Gruppo Italiano di Far macoepidemiologia nell'Anziano) database were used. During the period from 1988 to 1995, the most frequently prescribed antihypertensive drugs were ca lcium channel blockers (47%) followed by diuretics (37%), ACE-inhibitors (3 3%) and beta-blockers (5.5%). Changes over time in the use of these drugs w ere analysed: ACE-inhibitors had the greatest increase in use over time. Ca lcium channel blockers, ACE-inhibitors and beta-blockers were usually presc ribed to the youngest patients (aged < 65 years), while diuretics to the ol dest. Calcium channel blockers were prescribed to 60% of patients with myoc ardial infarction and to 55% of those with congestive heart failure. In con clusion, our study demonstrates that the Italian physicians very often pres cribe drugs like calcium channel blockers and ACE-inhibitors. Among these p harmacological agents, enalapril (twice per day) and slow release calcium c hannel blockers are the most frequently prescribed drugs. (C) 2000 Academic Press.