A comparative study of recommended drugs by guidelines or consensuses for cardiovascular and cerebrovascular diseases with the world health organization model list of essential medicines and the national essential medicines list_Chinese Journal of Evidence-Based Medicine

Authors：

SHI Yuqing ^1,2,3,4 , SONG Xia ^1,2,3,4 , LI Siyu ^1,2,3,5 , CHEN Zhe ^1,2,3,4 , DIAO Sha ^1,2,3,5 , ZOU Kun ^1,2,3 , LIU Yan ^1,2,3,4 , LIU Dan ^1,2,3,4 , ZENG Linan ^1,2,3 , ZHANG Aimin ⁶ , XIAO Hongjie ⁶ ,  ZHANG Lingli ^1,2,3,7

1. Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University; Children's Medicine Key Laboratory of Sichuan Province Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. NMPA Key Laboratory for Technical Research on Drug Products in vitro and in vivo Correlation, Chengdu 610041, P. R. China;
3. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu 610041, P. R. China;
4. West China School of Pharmacy, Sichuan University, Chengdu 610041, P. R. China;
5. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
6. Medical Instrument Management Center, National Health Commission of the People’s Republic of China, Beijing 100044, P. R. China;
7. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

ZHANG Lingli, Email: zhanglingli@scu.edu.cn

Keywords：

Cardiovascular and cerebrovascular diseases; Medicines; Guidelines; Expert consensus; Essential medicines list

DOI：

10.7507/1672-2531.202407127

Video：

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Objective To compare the recommended medicines of cardiovascular and cerebrovascular diseases guidelines, expert consensus, or diagnosis and treatment specifications with essential medicines from the 2023 World Health Organization Model List of Essential Medicines (WHO-EML) and the 2018 National Essential Medicine List (NEML) in differences and similarities. Methods Six guideline websites and one association website including Guidelines International Network and National Guideline Clearinghouse, etc. were searched until July 2023. The latest cardiovascular and cerebrovascular diseases guidelines, expert consensus, diagnosis and treatment specifications involving medicine treatment were included, and we extracted the data (year, title, target disease, authors and recommended medicines), and the statistical analysis of recommended medicines included in the WHO-EML and NEML was performed by Excel 2016. Results A total of 83 guidelines, expert consensus, and diagnosis and treatment specifications were included, covering cerebrovascular diseases, ischemic heart diseases, hypertensive diseases, chronic rheumatic heart diseases, diseases of arteries, arterioles and capillaries and other unspecified circulatory system disorders. They were issued from 2002 to 2023. 55 (66.3%) were published in the past 5 years. For the 246 recommended medicines, they were divided into 14 categories according to the pharmacological effect. 27.2% (67/246) were included in WHO-EML and 32.9% (81/246) were included in NEML, among which 41 medicines were included both in WHO-EML and NEML, 40 in NEML only, 26 in WHO-EML only, and 139 in neither. The number of excluded medicines in antihypertensive medicines, lipid-regulating medicines and antiatherosclerotic medicines and anticoagulants exceeded 10. Conclusion The number of cardiovascular and cerebrovascular disease guidelines, expert consensus, and diagnosis and treatment specifications recommended for WHO-EML and NEML is lower than 50%, and the coverage rate of NEML for cardiovascular and cerebrovascular disease guidelines recommended treatment medicines is higher than that of WHO-EML.

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2.	中华人民共和国国家卫生健康委员会官方网站. 2022中国卫生健康统计年鉴. 2022.
3.	崔洪瑞, 黄丽, 谭清立. WHO基本药物清单与国家基本药物目录及医保目录中精神障碍药物收录情况比较. 中国药物经济学, 2023, 18(9): 26-31,35.
4.	董途, 马鑫, 马姝丽, 等. WHO儿童基本药物示范目录、WHO和我国基本药物目录中抗感染药物的比较与启示. 中国药房, 2023, 34(11): 1293-1297.
5.	刘博, 宋钦, 王雪, 等. 《国家基本药物目录》(2012年版和2018年版)与《世界卫生组织基本药物标准清单》(2023版)中眼科用药的比较和分析. 中南药学, 2024, 22(7): 1934-1938.
6.	唐晓章, 谭娟, 李艳艳, 等. 现行《世界卫生组织基本药物标准清单》《国家基本药物目录》收录呼吸系统药物对比分析. 中国药业, 2023, 32(18): 29-33.
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8.	国家卫生健康委员会. 国家基本药物目录: 2018版. 2018.
9.	国家医保信息业务编码标准数据库动态维护. ICD-10医保版. 2023.
10.	张玉. 全国高级卫生专业技术资格考试指导: 医院药学. 北京: 人民卫生出版社, 2022.
11.	Fan J, Li X, Yu X, et al. Global burden, risk factor analysis, and prediction study of ischemic stroke, 1990-2030. Neurology, 2023, 101(2): e137-e150.
12.	Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol, 2020, 76(25): 2982-3021.
13.	薛慧颖, 李娟. 解读2018年版《国家基本药物目录》. 医药导报, 2019, 38(1): 1-8.
14.	胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告2018》概要. 中国循环杂志, 2019, 34(3): 209-220.
15.	Psaty BM, Lumley T, Furberg CD. Meta-analysis of health outcomes of chlorthalidone-based vs nonchlorthalidone-based low-dose diuretic therapies. JAMA, 2004, 292(1): 43-44.
16.	Pareek AK, Messerli FH, Chandurkar NB, et al. Efficacy of low-dose chlorthalidone and hydrochlorothiazide as assessed by 24-h ambulatory blood pressure monitoring. J Am Coll Cardiol, 2016, 67(4): 379-389.
17.	Roush GC, Ernst ME, Kostis JB, et al. Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium: systematic review and meta-analyses. J Hypertens, 2016, 34(1): 11-19.
18.	Zou Z, Xi GL, Yuan HB, et al. Telmisartan versus angiotension-converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials. J Hum Hypertens, 2009, 23(5): 339-349.
19.	Naci H, Brugts JJ, Fleurence R, et al. Comparative benefits of statins in the primary and secondary prevention of major coronary events and all-cause mortality: a network meta-analysis of placebo-controlled and active-comparator trials. Eur J Prev Cardiol, 2013, 20(4): 641-657.
20.	Adams SP, Sekhon SS, Tsang M, et al. Fluvastatin for lowering lipids. Cochrane Database Syst Rev, 2018, 3(3): CD012282.
21.	杨琛. 氟伐他汀缓释片有效性与安全性的研究进展. 药品评价, 2020, 17(23): 1-3.
22.	López-López JA, Sterne JAC, Thom HHZ, et al. Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis. BMJ, 2017, 359: j5058.
23.	Scott G, Gillon TE, Pels A, et al. Guidelines-similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension. Am J Obstet Gynecol, 2022, 226(2S): S1222-S1236.
24.	Sibai BM, Mabie WC, Shamsa F, et al. A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy. Am J Obstet Gynecol, 1990, 162(4): 960-966.
25.	张希龙. 高血压治疗的研究进展. 中国城乡企业卫生, 2021, 36(7): 56-59.
26.	Kitzmiller JP, Groen DK, Phelps MA, et al. Pharmacogenomic testing: relevance in medical practice: why drugs work in some patients but not in others. Cleve Clin J Med, 2011, 78(4): 243-257.
27.	陈灵芝, 王庆广, 杜春艳, 等. 替格瑞洛改善大动脉粥样硬化性脑梗死患者氯吡格雷抵抗的研究. 中国医刊, 2021, 56(7): 761-764.
28.	Oh MS, Yu KH, Lee JH, et al. Aspirin resistance is associated with increased stroke severity and infarct volume. Neurology, 2016, 86(19): 1808-1817.
29.	Zheng AS, Churilov L, Colley RE, et al. Association of aspirin resistance with increased stroke severity and infarct size. JAMA Neurol, 2013, 70(2): 208-213.
30.	徐荣彬, 杨俊, 韩晟, 等. 吲哚布芬预防心脑血管事件效果和安全性的Meta分析. 中国循证心血管医学杂志, 2017, 9(5): 532-538.
31.	丁香园. 中国缺血性脑卒中血脂管理指导规范. 实用心脑肺血管病杂志, 2015, (4): 117-117.
32.	National Institute for Health and Clinical Excellence. Acute coronary syndromes. 2020.
33.	中华医学会, 中华医学会临床药学分会, 中华医学会杂志社, 等. ST段抬高型心肌梗死基层合理用药指南. 中华全科医师杂志, 2021, 20(4): 397-409.
34.	中华医学会, 中华医学会临床药学分会, 中华医学会杂志社, 等. 稳定性冠心病基层合理用药指南. 中华全科医师杂志, 2021, 20(4): 423-434.
35.	中华医学会, 中华医学会临床药学分会, 中华医学会杂志社, 等. 冠心病心脏康复基层合理用药指南. 中华全科医师杂志, 2021, 20(3): 311-320.
36.	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 稳定性冠心病基层诊疗指南(2020年). 中华全科医师杂志, 2021, 20(3): 265-273.
37.	Unger T, Borghi C, Charchar F, et al. 2020 international society of hypertension global hypertension practice guidelines. J Hypertens, 2020, 38(6): 982-1004.
38.	Ai C, Zhang S, He Q, et al. Comparing the combination therapy of ezetimibe and atorvastatin with atorvastatin monotherapy for regulating blood lipids: a systematic review and meta-analyse. Lipids Health Dis, 2018, 17(1): 239.
39.	Ara R, Tumur I, Pandor A, et al. Ezetimibe for the treatment of hypercholesterolaemia: a systematic review and economic evaluation. Health Technol Assess, 2008, 12(21): iii,xi-xiii,1i-212i.
40.	国家卫生健康委, 国家发展改革委, 国家工业信息化部, 等. 关于印发国家基本药物目录管理办法的通知(国卫药政发). 2015.
41.	韩雨倍, 刘文臣, 陈琛, 等. 2023年版WHO基本药物示范目录特点分析及启示. 中国卫生政策研究, 2024, 17(2): 53-58.

1. World Health Organization. Global health estimates: life expectancy and leading causes of death and disability. 2024.
2. 中华人民共和国国家卫生健康委员会官方网站. 2022中国卫生健康统计年鉴. 2022.
3. 崔洪瑞, 黄丽, 谭清立. WHO基本药物清单与国家基本药物目录及医保目录中精神障碍药物收录情况比较. 中国药物经济学, 2023, 18(9): 26-31,35.
4. 董途, 马鑫, 马姝丽, 等. WHO儿童基本药物示范目录、WHO和我国基本药物目录中抗感染药物的比较与启示. 中国药房, 2023, 34(11): 1293-1297.
5. 刘博, 宋钦, 王雪, 等. 《国家基本药物目录》(2012年版和2018年版)与《世界卫生组织基本药物标准清单》(2023版)中眼科用药的比较和分析. 中南药学, 2024, 22(7): 1934-1938.
6. 唐晓章, 谭娟, 李艳艳, 等. 现行《世界卫生组织基本药物标准清单》《国家基本药物目录》收录呼吸系统药物对比分析. 中国药业, 2023, 32(18): 29-33.
7. World Health Organization. The WHO model lists of essential medicines. 2023.
8. 国家卫生健康委员会. 国家基本药物目录: 2018版. 2018.
9. 国家医保信息业务编码标准数据库动态维护. ICD-10医保版. 2023.
10. 张玉. 全国高级卫生专业技术资格考试指导: 医院药学. 北京: 人民卫生出版社, 2022.
11. Fan J, Li X, Yu X, et al. Global burden, risk factor analysis, and prediction study of ischemic stroke, 1990-2030. Neurology, 2023, 101(2): e137-e150.
12. Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol, 2020, 76(25): 2982-3021.
13. 薛慧颖, 李娟. 解读2018年版《国家基本药物目录》. 医药导报, 2019, 38(1): 1-8.
14. 胡盛寿, 高润霖, 刘力生, 等. 《中国心血管病报告2018》概要. 中国循环杂志, 2019, 34(3): 209-220.
15. Psaty BM, Lumley T, Furberg CD. Meta-analysis of health outcomes of chlorthalidone-based vs nonchlorthalidone-based low-dose diuretic therapies. JAMA, 2004, 292(1): 43-44.
16. Pareek AK, Messerli FH, Chandurkar NB, et al. Efficacy of low-dose chlorthalidone and hydrochlorothiazide as assessed by 24-h ambulatory blood pressure monitoring. J Am Coll Cardiol, 2016, 67(4): 379-389.
17. Roush GC, Ernst ME, Kostis JB, et al. Dose doubling, relative potency, and dose equivalence of potassium-sparing diuretics affecting blood pressure and serum potassium: systematic review and meta-analyses. J Hypertens, 2016, 34(1): 11-19.
18. Zou Z, Xi GL, Yuan HB, et al. Telmisartan versus angiotension-converting enzyme inhibitors in the treatment of hypertension: a meta-analysis of randomized controlled trials. J Hum Hypertens, 2009, 23(5): 339-349.
19. Naci H, Brugts JJ, Fleurence R, et al. Comparative benefits of statins in the primary and secondary prevention of major coronary events and all-cause mortality: a network meta-analysis of placebo-controlled and active-comparator trials. Eur J Prev Cardiol, 2013, 20(4): 641-657.
20. Adams SP, Sekhon SS, Tsang M, et al. Fluvastatin for lowering lipids. Cochrane Database Syst Rev, 2018, 3(3): CD012282.
21. 杨琛. 氟伐他汀缓释片有效性与安全性的研究进展. 药品评价, 2020, 17(23): 1-3.
22. López-López JA, Sterne JAC, Thom HHZ, et al. Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis. BMJ, 2017, 359: j5058.
23. Scott G, Gillon TE, Pels A, et al. Guidelines-similarities and dissimilarities: a systematic review of international clinical practice guidelines for pregnancy hypertension. Am J Obstet Gynecol, 2022, 226(2S): S1222-S1236.
24. Sibai BM, Mabie WC, Shamsa F, et al. A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy. Am J Obstet Gynecol, 1990, 162(4): 960-966.
25. 张希龙. 高血压治疗的研究进展. 中国城乡企业卫生, 2021, 36(7): 56-59.
26. Kitzmiller JP, Groen DK, Phelps MA, et al. Pharmacogenomic testing: relevance in medical practice: why drugs work in some patients but not in others. Cleve Clin J Med, 2011, 78(4): 243-257.
27. 陈灵芝, 王庆广, 杜春艳, 等. 替格瑞洛改善大动脉粥样硬化性脑梗死患者氯吡格雷抵抗的研究. 中国医刊, 2021, 56(7): 761-764.
28. Oh MS, Yu KH, Lee JH, et al. Aspirin resistance is associated with increased stroke severity and infarct volume. Neurology, 2016, 86(19): 1808-1817.
29. Zheng AS, Churilov L, Colley RE, et al. Association of aspirin resistance with increased stroke severity and infarct size. JAMA Neurol, 2013, 70(2): 208-213.
30. 徐荣彬, 杨俊, 韩晟, 等. 吲哚布芬预防心脑血管事件效果和安全性的Meta分析. 中国循证心血管医学杂志, 2017, 9(5): 532-538.
31. 丁香园. 中国缺血性脑卒中血脂管理指导规范. 实用心脑肺血管病杂志, 2015, (4): 117-117.
32. National Institute for Health and Clinical Excellence. Acute coronary syndromes. 2020.
33. 中华医学会, 中华医学会临床药学分会, 中华医学会杂志社, 等. ST段抬高型心肌梗死基层合理用药指南. 中华全科医师杂志, 2021, 20(4): 397-409.
34. 中华医学会, 中华医学会临床药学分会, 中华医学会杂志社, 等. 稳定性冠心病基层合理用药指南. 中华全科医师杂志, 2021, 20(4): 423-434.
35. 中华医学会, 中华医学会临床药学分会, 中华医学会杂志社, 等. 冠心病心脏康复基层合理用药指南. 中华全科医师杂志, 2021, 20(3): 311-320.
36. 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 稳定性冠心病基层诊疗指南(2020年). 中华全科医师杂志, 2021, 20(3): 265-273.
37. Unger T, Borghi C, Charchar F, et al. 2020 international society of hypertension global hypertension practice guidelines. J Hypertens, 2020, 38(6): 982-1004.
38. Ai C, Zhang S, He Q, et al. Comparing the combination therapy of ezetimibe and atorvastatin with atorvastatin monotherapy for regulating blood lipids: a systematic review and meta-analyse. Lipids Health Dis, 2018, 17(1): 239.
39. Ara R, Tumur I, Pandor A, et al. Ezetimibe for the treatment of hypercholesterolaemia: a systematic review and economic evaluation. Health Technol Assess, 2008, 12(21): iii,xi-xiii,1i-212i.
40. 国家卫生健康委, 国家发展改革委, 国家工业信息化部, 等. 关于印发国家基本药物目录管理办法的通知(国卫药政发). 2015.
41. 韩雨倍, 刘文臣, 陈琛, 等. 2023年版WHO基本药物示范目录特点分析及启示. 中国卫生政策研究, 2024, 17(2): 53-58.

Chinese Journal of Evidence-Based Medicine

Latest ArticlesA comparative study of recommended drugs by guidelines or consensuses for cardiovascular and cerebrovascular diseases with the world health organization model list of essential medicines and the national essential medicines list

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