Hypolipidemic and antihypertensive therapy in diabetic patients in the Czech Republic: notes on the VZP (General Health Insurance Company) Data

Czech version

Authors: Michaela Šnejdrlová ^1,2; Richard Češka ^1,2; Denisa Janíčková-Žďárská ³; Petr Honěk ⁴; Pavel Dušek ^5,6; Tomáš Pavlík ^5,6; Milan Kvapil ³
Authors‘ workplace: Centrum preventivní kardiologie VFN Praha, vedoucí centra prof. MUDr. Richard Češka, CSc., FEFIM, FACP ¹; III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA ²; Interní klinika 2. LF UK a FN Motol Praha, přednosta prof. MUDr. Milan Kvapil, CSc., MBA ³; Všeobecná zdravotní pojišťovna České republiky, Praha, ředitel Ing. Zdeněk Kabátek ⁴; Ústav zdravotnických informací a statistiky, Praha, ředitel doc. RNDr. Ladislav Dušek, Ph. D. ⁵; Institut biostatistiky a analýz LF MU, MU, Brno, ředitel doc. RNDr. Ladislav Dušek, Ph. D. ⁶
Published in: Vnitř Lék 2015; 61(Suppl 3): 30-37
Category: Original Contributions

Overview

Diabetes mellitus and in particular type 2 diabetes mellitus is one of the most important risk factors of cardiovascular disease. To influence cardiovascular risk there is enormous important not only positive influence of glycemia, but also the treatment of diabetic dyslipidemia and hypertension. The present work provides an analysis of lipid-lowering and antihypertensive therapy for all diabetics registered with General Health Insurance Company in the period 2010–2013. In this time 866 570 patients with diabetes mellitus registered with General Health Insurance Company were treated, the majority of them were diabetics independent on insulin. Approximately half of the patients were observed by dialectologists and half of them by the doctors of other specialization. Out of antihypertensive medication, patients were most often treated by drugs that affect the renin-angiotensin system, as well as beta-blockers and diuretics. Prescription of the lipid-lowering therapy, especially prescription of statins, in accordance with the guidelines, is increasing, but remains insufficient (at 2013 43.6% diabetics treated by dialectologists and 51.3% diabetics treated by GP´s didn´t have lipid lowering therapy). Inadequate use of combination lipid-lowering therapy was recorded too, still represented mainly by combination of statin and fibrate, but in coming years we expect (based on the positive results of the subanalysis IMPROVE-IT study), an increase of combination therapy statin and ezetimibe.

Keywords:
diabetes mellitus type 2 – diabetic dyslipidemia – ezetimibe – cardiovacular risk – statins

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