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Gaps between affluent and underdeveloped nations and between city and rural populations are apparent in many ways, and among the most devastating may be in the penetration of proven medical therapy for secondary prevention of cardiovascular diseases, suggests a survey of 628 communities in 17 high-, middle-, and low-income countries.
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"Effective preventive drugs for coronary heart disease and stroke are underused globally, with striking variation between countries at different stages of economic development," write the authors, led by Dr Salim Yusuf (McMaster University, Hamilton, ON), based on their findings from the Prospective Urban Rural Epidemiology (PURE) study. "Even the use of accessible and inexpensive treatments such as aspirin . . . varied sevenfold between low-income and high-income countries," they write; statin use varied 20-fold. And even in the highest-income countries in the survey, only one-half to two-thirds of people with a history of MI or stroke were taking either aspirin or statins.
"For every group of countries classified by economic development, rates of drug use were consistently lower in rural than in urban settings." The analysis—which looked at the use of antiplatelets, beta blockers, ACE inhibitors or angiotensin receptor blockers (ARBs), statins, and other agents among persons with coronary heart disease or stroke—was published online today in the Lancet to coincide with its presentation by Yusuf here at the European Society of Cardiology (ESC) 2011 Congress.
http://www.theheart.org/article/1268617.do?utm_campaign=newsletter&utm_medium=email&utm_source=20110828_ESC_AM_28Aug
