Background: One of the most important risk factors for stroke is hypertension. A number of studies have\r\nattempted to identify the most effective anti-hypertensive therapeutic group for stroke prevention. Using an\r\nepidemiologic approach we aimed to find correlations based on Hungarian data on stroke-mortality and on\r\nprescription routine of anti-hypertensive therapeutics in three different counties, showing significant difference in\r\nstroke mortality.\r\nMethods: We have used the official yearly reports on stroke-mortality for the period 2003-2008. Based on the\r\nsignificant differences in the change in mortality due to stroke three counties were selected: Baranya, Bekes and\r\nHajdu-Bihar. The usage of antihypertensive therapeutic groups was analyzed. The correlation of stroke mortality\r\ndifference and different antihypertensive treatment habits was analyzed by using normality test, time series\r\nanalyses, correlation coefficient, paired samples test, one sample test and chi-square test.\r\nResults: For the year 2003 stroke-mortality standardized with the county population number was highest in county\r\nBekes, followed by county Baranya and county Hajdu-Bihar. For each year stroke mortality has shown significant (p <\r\n0.0001) difference between the three counties and the ranking/order of the counties has been preserved over time.\r\nDuring the period of our study, an increase in the number of days of treatment was observed for most of the antihypertensive\r\ndrugs listed. We have observed that the increased use of high-ceiling diuretics resulted in a mortality\r\nadvantage, and the reduction in use of calcium channel blockers with direct cardiac effect had negative consequences.\r\nConclusions: The authors acknowledge that by limiting the study to three counties the findings cannot be\r\ngeneralized to the whole Hungarian population. Two trends can still be identified:\r\ni) increased number of days of treatment (and therefore the probable use) of high-ceiling diuretics is associated\r\nwith reduction in mortality due to stroke and its immediate complications; ii) reduction in the use of nondihidropiridin\r\nCCBs does not seem justified, as their use appears to be advantageous in stroke prevention. Authors\r\nput emphasis on the importance of the adherence of the patients to the preventive therapies. Health care\r\nprofessionals could provide an important added value to the life long preventive therapies by improving the\r\ncompliance of their patients, giving personalized care and advice.
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