European Journal of Clinical Pharmacology

, Volume 64, Issue 12, pp 1223–1229 | Cite as

Utilisation of angiotensin receptor blockers in Sweden: combining survey and register data to study adherence to prescribing guidelines

  • Pia Frisk
  • Tor-Olov Mellgren
  • Niklas Hedberg
  • Anita Berlin
  • Fredrik Granath
  • Björn Wettermark
Pharmacoepidemiology and Prescription



Angiotensin receptor blockers (ARBs) offer a new treatment alternative for patients with hypertension and heart failure. Due to comparatively high prices, most guidelines suggest ARBs be restricted to patients intolerant to angiotensin-converting enzyme inhibitors (ACEi). We analysed the prescribing patterns of ARBs in Sweden by combining prescription register data with patient self-reported data.


Survey data from 517 patients dispensed ARBs in 55 pharmacies and data on dispensed prescriptions from the Swedish Prescribed Drug Register were used to study indication, comorbidity and whether ARBs were initiated as first-line treatment.


In 2006, ARBs were dispensed to 3.6% of the Swedish population. The survey showed that 92% used them for hypertension. Register data showed that 23% of all patients initiated on an ARB had not been prescribed any other antihypertensive drugs 1 year prior to the initiation.


ARBs are commonly used in Sweden, mainly to treat hypertension. Adherence to prescribing guidelines may be improved.


Angiotensin receptor blockers Drug utilisation Guidelines Prescribing ACE inhibitors Patient survey 



The staff at the pharmacies involved in the survey are gratefully acknowledged for their participation. Andrejs Leimanis at the Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden, is gratefully acknowledged for part of the data analysis. Ulrika Benholm and Kristina Lönngren at the National Corporation of Swedish Pharmacies, Stockholm, Sweden, are gratefully acknowledged for their part in the study preparation. We also acknowledged Dr. Brian Godman, UK, for valuable comments.

The study was funded by the Swedish Pharmaceutical Benefits Board.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Pia Frisk
    • 1
  • Tor-Olov Mellgren
    • 2
  • Niklas Hedberg
    • 2
  • Anita Berlin
    • 1
  • Fredrik Granath
    • 3
  • Björn Wettermark
    • 3
    • 4
  1. 1.National Corporation of Swedish Pharmacies (Apoteket AB)StockholmSweden
  2. 2.Swedish Pharmaceutical Benefits Board (LFN)StockholmSweden
  3. 3.Karolinska Institutet, Centre for Pharmacoepidemiology and Clinical Epidemiology Unit, Department of MedicineKarolinska University HospitalStockholmSweden
  4. 4.Karolinska Institutet, Division of Clinical Pharmacology, Department of Laboratory MedicineKarolinska University HospitalStockholmSweden

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