Scientific Development and Data Analyst National Institute of Public Health Cuernavaca, Mexico
Background: Non-transmissible chronic diseases usually coexist and require daily pharmacotherapy for disease management. The long-term use of antihypertensive, antidiabetics, or non-steroidal anti-inflammatories has shown metabolic impact on adult patients' health status.
Objectives: This study aimed to show the association of common chronic drug use with dyslipidemia and renal biomarkers in an open Mexican cohort study with fourteen years of follow-up.
Methods: We analyzed data from the three assessments of the Mexican Health Workers Cohort Study. We included the participant’s cohort aged >18 years and older, 9,522 at recruitment, 2,075 participants, and 1,299 in the second and third assessments. The common utilization (at least twice a week) of antihypertensive, antidiabetic, and NSAI drugs, diagnoses, and comorbidities, were ascertained through a standardized self-administered questionnaire. Serum lipid profile (TC, TG, LDL, and HDL), serum glucose, uric acid, and renal biomarkers (serum creatinine, Cystatin C, and NGAL) values were determined from fasting serum samples and then dichotomized according to international cutoffs values. To evaluate the longitudinal drug effect, we included only the participants with at least two diagnoses and drug utilization measures. The study associations were assessed with fixed-effect logistic models adjusted by age, BMI, glucose, and comorbidities.
Results: During the study, there were 2,248 participants with Hypertension (H), 645 participants with type 2 diabetes (T2D), 739 participants with both diseases (H + T2D), and 10,058 without any of these. Beta-blocker and thiazide diuretics utilization was inversely associated with high total cholesterol (BB OR= 0.4, 95%IC 0.2-0.8; TD OR 0.5, 95%IC 0.9-1.0) and high LDL (BB OR 0.69, 95%IC 0.4-0.9; TD OR= 0.6, 95%IC 0.3-1.0) and ACEI utilization with high creatinine (OR 0.04, 95%IC 0.002-0.7). The use of glibenclamide was associated with high triglycerides (OR 2.6, 95%IC 1.0-7.0) in participants with T2D. Chronic use of acetylsalicylic acid was inversely associated with high triglycerides, low HDL, and high LDL. No significant associations were observed with serum Cystatin C in participants of the 2017-2018 wave.
Conclusions: A significant effect on lipid profile and renal biomarkers with the chronic utilization of antihypertensive, antidiabetic, and NSAI drug types was observed among Mexican cohort participants.
