April 30, 1999

The increase in the use of calcium channel blockers and ACE inhibitors to treat hypertension – a 10-year trend that is not supported by national treatment guidelines – has been paralleled by a marked increase in advertising such drugs to physicians, says an MGH research group. Although their findings, published in the April 20 issue of Circulation, cannot prove that advertising has influenced how physicians choose which drugs to prescribe, the authors believe pharmaceutical marketing efforts may help explain the switch away from older, less expensive medications such as beta blockers and diuretics.

"The total number of ad pages for calcium channel blockers nearly quadrupled during the study period, making them the most heavily advertised medication of any type during 1996, a year during which we found no ads at all for diuretics or beta blockers," says Thomas Wang, MD, a senior medical resident at the MGH and the paper’s first author.

The research team, which also included Randall Stafford, MD, PhD, and John Ausiello of the MGH General Medicine Division, analyzed the January, April, July and October issues of The New England Journal of Medicine from 1985 through 1996 to determine the proportion of total ad pages devoted to particular classes of medication. They found that ads for calcium channel blockers increased from 4.6 percent of pages in 1985 to 26.9 percent of pages in 1996, while ads for beta blockers and diuretics decreased from 12.4 percent and 4.2 percent, respectively, to zero. Ads for ACE inhibitors increased at an insignificant level.

Stafford says: "We certainly do not suggest that patients stop taking a medication that is working for them or question their physician’s decisions, but patients who are about to start medication may want to discuss the benefits of the various types of drugs with their doctors before deciding on their individual treatment plans."