Ziekenhuisopname door bijwerkingen: verschillen tussen man en vrouw*

Objective

Cardiovascular disease in women is often underestimated. Drug effects of cardiovascular drugs differ between the sexes because of pharmacokinetic and pharmacodynamic differences. Adverse drug reactions (ADRs) within these drug classes may have serious consequences, leading to hospital admission. We aimed to study differences between men and women in hospital admissions for adverse drug reactions due to cardiovascular drugs.

Design

Observational research.

Method

We conducted a nationwide study of all hospital admissions between 2000 and 2005 with data from the Dutch National Medical Register. Relative risks were calculated of hospital admission due to the different cardiovascular drug groups for women compared to men. By an ecological design, risks were adjusted for the total number of Dutch inhabitants, and total number of prescriptions.

Results

In total, 14,207 of the hospital admissions (34% of all ADR related admissions) were attributed to cardiovascular drugs (7,690 in women (54%; 95%-CI: 53-55)). ‘Anticoagulants and salicylates’ (n = 8,988), ‘high and low ceiling diuretics’ (n = 2,242) and ‘cardiotonic glycosides’ (n = 932) were responsible for the majority of the ADR-related hospital admissions. The most pronounced sex-differences were seen in low ceiling diuretics (RR: 3.44; 95% CI: 2.66, 4.43), cardiotonic glycosides (RR: 1.92; 95%-CI: 1.66-2.21), high ceiling diuretics (RR: 1.73; 95%-CI: 1.57-1.91) and coronary vasodilators (RR: 0.66; 95%-CI: 0.56-0.78).

Conclusion

Clear sex differences exist in ADRs requiring hospital admission for different cardiovascular drug groups. Sex differences should be taken into account in the prescription and evaluation of drugs.

Conflict of interest: none declared. Financial support: none declared.