PHARMACOM LLC

A Consulting Company

February 2020

Diuretics Most Effective First-Line Antihypertensives

A comparative effectiveness analysis found that thiazide diuretics were more effective than angiotensin-converting enzyme (ACE) inhibitors as first-line medications for hypertension. The analysis included records from nearly 5 million patients in the US, Germany, Japan, and South Korea who began treatment with a single antihypertensive agent. Patients were prescribed ACE inhibitors (48%), diuretics (17%), dihydropyridine calcium channel blockers (CCBs, 16%), angiotensin receptor blockers (15%), or non-dihydropyridine CCBs (3%). Thiazide and thiazide-like diuretics were associated with lower risks of heart attack, stroke, and hospitalization for heart failure compared to ACE inhibitors. Diuretics also had a better safety profile than ACE inhibitors. Non-dihydropyridine CCBs were the least effective class of antihypertensives.

Influenza Vaccination Rates Low in Pregnant Women

The CDC reports that flu vaccination rates among pregnant women remain low. Only about half of pregnant women received the flu vaccine during the 2017-2018 flu season. This is concerning because pregnant women are more likely to become seriously ill from the flu than non-pregnant women. The most common reasons women gave for not getting the flu vaccine were the belief that the vaccine was not effective and fears that the vaccine may harm the baby.

Patients with Diabetes Turning to Black Market

Some patients with chronic diseases are turning to the black market to obtain medications. The major causes are lack of access and affordability, even among patients with health insurance. Use of the black market to obtain medications and supplies is especially prominent among patients with diabetes. The price of insulin has tripled over the last decade, and refills of medications may be held up because of provider delays and prior authorization required by insurers. Patients who cannot afford diabetes medications are turning to the black market for lower prices and/or rationing their doses.

High Blood Pressure Increases Earlier in Women than Men

High blood pressure starts at a younger age and increases more rapidly in women than men. Analysis of longitudinal data from more than 32,000 men and women in the US found that the steeper increase in blood pressure began in women in their 20s and persisted as the women aged. These findings challenge the belief that vascular disease typically develops 10 to 20 years later in women compared to men. The authors suggest that earlier onset of high blood pressure may set the stage for cardiovascular disease in women, and that vascular disease may present differently in women than men.

February is National Heart Month

February is Low Vision Awareness Month