Advertising May Influence Physicians' Choice Of Blood Pres...( e levels. The most established of thes...),Health

e levels. The most established of these antihypertensive drugs are diuretics, which rid the body of excess fluids and salts, and beta blockers, which reduce the heart rate and its output of blood. The study's authors note that these drugs -- which now are available in low-cost, generic versions -- are the only blood pressure medications proven in large-scale studies to reduce deaths from cardiovascular disease.

Two of the newer classes of drugs are ACE (angiotensin-converting enzyme) inhibitors, which interfere with production of a chemical that constricts arteries, and calcium channel blockers, which reduce the heart rate and relax blood vessels. In spite of the scientific evidence favoring the older drugs, the use of the newer calcium channel blockers and ACE inhibitors has increased dramatically since the mid-1980s. In 1995, for example, calcium channel blockers accounted for 38 percent of antihypertensive prescriptions, ACE inhibitors were prescribed 33 percent of the time, but beta blockers and diuretics were prescribed only 19 percent of the time.

"There is a good amount of information suggesting that physicians aren't following the national guidelines for treating hypertension, which call for beta blockers and diuretics to be used as first-line treatment for most patients," says Randall Stafford, MD, PhD, of the MGH Institute for Health Policy and General Medicine Division and the study's senior author. "We wanted to investigate other factors that might be behind that trend, particularly whether advertising might have an effect."

The research team, which also included John Ausiello of the MGH General Medicine Division, analyzed the January, April, July and October issues of the New England Journal of Medicine from 1985 through 1996 to determine the proportion of total ad pages devoted to particular classes of medication. They found that ads for calcium channel blockers increased from 4.6 percent of pages in 1985 to 26.9 percent of pages in
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Contact: Susan McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
20-Apr-1999

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