May 2010 Br J Cardiol 2010;17:s6-s9
Neil Poulter
Impact of hypertension Epidemiological data have established a strong direct relationship between increased BP and raised cardiovascular (CV) disease risk. For individuals aged 40–69 years, each increment in systolic BP of 20 mmHg or diastolic BP of 10 mmHg doubles the risk of CV disease (i.e. stroke, ischaemic heart disease, and other vascular diseases) across the entire BP range.3 Figure 1. Prevalence of hypertension worldwide The World Health Organization has identified high BP as one of the most important preventable causes of premature morbidity and mortality. Antihypertensive drugs have convincingly been shown to be effective treatmen
May 2010 Br J Cardiol 2010;17:s10-s12
Theresa McDonagh
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May 2010 Br J Cardiol 2010;17:s13-s14
Mark Kearney
Renal disease and diabetes Microalbuminuria is known to be a marker of increased cardiovascular (CV) risk. It is not clear whether reducing microalbuminuria on its own is associated with an improved cardiovascular prognosis, but in secondary analyses from studies of angiotensin receptor blockers (ARBs) in people with type 2 diabetes, reduction in albuminuria was associated with a decreased risk of a CV event. Observational analyses from the RENAAL trial found that the magnitude of albuminuria reduction predicted the reduced risk of CV events (figure 1).1 Figure 1. Kaplan-Meier curves for cardiovascular (CV) and heart failure end points, strat
May 2010 Br J Cardiol 2010;17:s14-s15
David Taylor, Mark Davis
This brief paper considers how such cost pressures may affect the use of angiotensin receptor blockers (ARBs) in the NHS, given that although losartan is the first drug in this class to become generic in March 2010, others will quickly follow suit. Valsartan loses patent protection in 2011, with candesartan and irbesartan following in 2012. Indications for ARB use Recent data indicate that candesartan is presently the most widely used ARB in England, accounting for almost a third of all ARB prescriptions. This is in part because it has been competitively priced compared with other ARBs. In average prescription cost terms, candesartan has in r
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