Marjan W. Attaei|Rasha Khatib|Martin McKee|Scott A. Lear|Gilles R. Dagenais|Ehimario U. Igumbor|Khalid F Alhabib|Manmeet Kaur|Lanthe Kruger|Koon Teo|Fernando Lanas|Khalid Yusoff|Aytekin O?uz|Rajeev Gupta|Afzalhussein Yusufali|Ahmad Bahonar|Raman Kutty|Annika Rosengren|Viswanathan Mohan|Álvaro Avezum|Rita Yusuf|Andrzej Szuba|Sumathy Rangarajan|Clara K Chow|Salim Yusuf|Salim Yusuf|Sumathy Rangarajan|Koon Teo|Clara K Chow|Martin O’Donnell|Andrew Mente|Darryl P. Leong|Andrew Smyth|Philip Joseph|Shofiqul Islam|M Zhang|Weihong Hu|Chinthanie Ramasundarahettige|Gary Wong|Lovely Dayal|Amparo Casanova|Mahshid Dehghan|Gregory D. Lewis|Antonio Aliberti|Álvaro Reyes|Ahmed A. Zaki|Basil S. Lewis|B Zhang|D Agapay|Danielle M. Hari|E Milazzo|E Ramezani|F Hussain|F Shifaly|I. Patrick Kay|Julija Rimac|John G. Swallow|L Heldman|Maha Mushtaha|Maha Mushtaha|Mark Trottier|N Aoucheva|N Kandy|Pam Mackie|Rubén Solano|Siu Lim Chin|S Ramacham|Sadequa Shahrook|Sylvie Trottier|T Tongana|W Elsheikh|J Lindeman|Matt J. McQueen|Kellie Hall|Judy Keys|X Wang|J Keneth|Anitha Devanath|Rafael D??az|Andrés Orlandini|B Linetsky|S Toscanelli|Germana Casaccia|JM Maini Cuneo|Omar Rahman|Rita Yusuf|AK Azad|Khondkar Ayaz Rabbani|HM Cherry|Adnan Mannan|I Hassan|AT Talukdar|RB Tooheen|MU Khan|Mariz Sintaha|Tarzia Choudhury|Md Rabiul Haque|S Parvin|Álvaro Avezum|GB Oliveira
Availability and affordability of blood pressure-lowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data
McMaster University|Loyola University Medical Center|London School of Hygiene & Tropical Medicine|Simon Fraser University|Université Laval|University of the Western Cape|King Saud University|Post Graduate Institute of Medical Education and Research|North-West University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Universidad de La Frontera|Universiti Teknologi MARA|UCSI University|Istanbul Medeniyet University|Eternal Hospital|Dubai Health Authority|Isfahan University of Medical Sciences|Health Action by People|University of Gothenburg|Madras Diabetes Research Foundation|Instituto Dante Pazzanese de Cardiologia|Independent University|Wroclaw Medical University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|University of Sydney|Population Health Research Institute|Hamilton Health Sciences|McMaster University|McMaster University|Population Health Research Institute|Hamilton Health Sciences|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|University of Sydney|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Dubai Health Authority|University of Sydney|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Wroclaw Medical University|Wroclaw Medical University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Madras Diabetes Research Foundation|Population Health Research Institute|Hamilton Health Sciences|McMaster University|University of Sydney|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|University of Gothenburg|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Wroclaw Medical University|Population Health Research Institute|Hamilton Health Sciences|McMaster University|Loyola University Medical Center|University of Gothenburg|Isfahan University of Medical Sciences|Population Health Research Institute|McMaster University|Hamilton Health Sciences|Instituto Dante Pazzanese de Cardiologia
backgroundhypertension considered important risk factor cardiovascular diseases control poor worldwide aimed assess availability affordability blood pressurelowering medicines association use medicines blood pressure control countries varying levels economic developmentmethodswe analysed availability costs affordability blood pressurelowering medicines data recorded 626 communities 20 countries participating prospective urban rural epidemiological pure study medicines considered available present local pharmacy surveyed affordable combined cost less 20 households capacity pay related information availability affordability use medicines blood pressure control multilevel mixedeffects logistic regression models compared results highincome uppermiddleincome lowermiddleincome lowincome countries data india presented separately large generic pharmaceutical industry higher availability medicines countries economic levelfindingsthe availability two classes blood pressurelowering drugs lower lowincome middleincome countries except india highincome countries proportion communities four drug classes available 94 highincome countries 108 115 communities 76 india 68 90 71 uppermiddleincome countries 90 126 47 lowermiddleincome countries 107 227 13 lowincome countries nine 68 proportion households unable afford two blood pressurelowering medicines 31 lowincome countries 1069 3479 households 9 middleincome countries 5602 65 471 less 1 highincome countries 44 10 880 participants known hypertension communities four drug classes available likely use least one blood pressurelowering medicine adjusted odds ratio 223 95 ci 159312 p00001 combination therapy 153 113207 p0054 blood pressure controlled 206 169250 p00001 communities blood pressurelowering medicines available participants known hypertension households able afford four blood pressurelowering drug classes likely use least one blood pressurelowering medicine adjusted 142 95 ci 125162 p00001 combination therapy 126 108147 p00038 blood pressure controlled 113 100128 p00562 unable afford medicinesinterpretationa large proportion communities lowincome middleincome countries access one blood pressurelowering medicine available often affordable factors associated poor blood pressure control ensuring access affordable blood pressurelowering medicines essential control hypertension lowincome middleincome countriesfundingpopulation health research institute canadian institutes health research heart stroke foundation ontario canadian institutes health research strategy patient oriented research ontario spor support unit ontario ministry health longterm care pharmaceutical companies major contributions astrazeneca canada sanofi aventis france canada boehringer ingelheim germany amd canada servier glaxosmithkline novartis king pharma national local organisations participating countries