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Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: an analysis of the PURE study data
17 million people are estimated to die of cardiovascular
diseases worldwide every year.1
About 20% occur in
those with known vascular disease.2
Many of these
deaths could be avoided if the use3
of proven medicines
among patients with vascular disease (secondary
prevention) were increased. Clinical guidelines recommend
the use of four medicines for the secondary
prevention of cardiovascular disease: aspirin, β blockers,
angiotensin-converting enzyme (ACE) inhibitors or
angiotensin-II receptor blockers (ARBs), and statins.4
However, in a previous report from the Prospective
Urban Rural Epidemiology (PURE) study, only 25% of
patients with established cardiovascular disease were
taking aspirin, 17% β blockers, 20% ACE inhibitors or
ARBs, and 15% statins. In high-income countries, 11% of
eligible patients were not taking any of these medicines,
compared with 80% in low-income countries.