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 ^1,2,3,6 , ZHANG Aimin ⁷ , XIAO Hongjie ⁷ ,  ZHANG Lingli ^1,2,3,6,8

1. Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University; Children's Medicine Key Laboratory of Sichuan Province, 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. West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
7. Medical Instrument Management Center, National Health Commission of the People’s Republic of China, Beijing 100044, P. R. China;
8. 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 from inception to 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. Fifty-five (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.

Citation： SHI Yuqing, SONG Xia, LI Siyu, CHEN Zhe, DIAO Sha, ZOU Kun, LIU Yan, LIU Dan, ZENG Linan, ZHANG Aimin, XIAO Hongjie, ZHANG Lingli. 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, 2025, 25(7): 832-837. doi: 10.7507/1672-2531.202407127 Copy

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6.	唐曉章, 譚娟, 李艷艷, 等. 現行《世界衛生組織基本藥物標準清單》《國家基本藥物目錄》收錄呼吸系統藥物對比分析. 中國藥業, 2023, 32(18): 29-33.
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9.	國家醫保信息業務編碼標準數據庫動態維護. ICD-10醫保版. 2023.
10.	張玉. 全國高級衛生專業技術資格考試指導: 醫院藥學. 北京: 人民衛生出版社, 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.	薛慧穎, 李娟. 解讀2018年版《國家基本藥物目錄》. 醫藥導報, 2019, 38(1): 1-8.
14.	胡盛壽, 高潤霖, 劉力生, 等. 《中國心血管病報告2018》概要. 中國循環雜志, 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): CD012282.
21.	楊琛. 氟伐他汀緩釋片有效性與安全性的研究進展. 藥品評價, 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.	張希龍. 高血壓治療的研究進展. 中國城鄉企業衛生, 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.	陳靈芝, 王慶廣, 杜春艷, 等. 替格瑞洛改善大動脈粥樣硬化性腦梗死患者氯吡格雷抵抗的研究. 中國醫刊, 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.	徐榮彬, 楊俊, 韓晟, 等. 吲哚布芬預防心腦血管事件效果和安全性的Meta分析. 中國循證心血管醫學雜志, 2017, 9(5): 532-538.
31.	丁香園. 中國缺血性腦卒中血脂管理指導規范. 實用心腦肺血管病雜志, 2015, (4): 117-117.
32.	National Institute for Health and Clinical Excellence. Acute coronary syndromes. 2020.
33.	中華醫學會, 中華醫學會臨床藥學分會, 中華醫學會雜志社, 等. ST段抬高型心肌梗死基層合理用藥指南. 中華全科醫師雜志, 2021, 20(4): 397-409.
34.	中華醫學會, 中華醫學會臨床藥學分會, 中華醫學會雜志社, 等. 穩定性冠心病基層合理用藥指南. 中華全科醫師雜志, 2021, 20(4): 423-434.
35.	中華醫學會, 中華醫學會臨床藥學分會, 中華醫學會雜志社, 等. 冠心病心臟康復基層合理用藥指南. 中華全科醫師雜志, 2021, 20(3): 311-320.
36.	中華醫學會, 中華醫學會雜志社, 中華醫學會全科醫學分會, 等. 穩定性冠心病基層診療指南(2020年). 中華全科醫師雜志, 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.	國家衛生健康委, 國家發展改革委, 國家工業信息化部, 等. 關于印發國家基本藥物目錄管理辦法的通知(國衛藥政發). 2015.
41.	韓雨倍, 劉文臣, 陳琛, 等. 2023年版WHO基本藥物示范目錄特點分析及啟示. 中國衛生政策研究, 2024, 17(2): 53-58.

1. World Health Organization. Global health estimates: life expectancy and leading causes of death and disability. 2024.
2. 中華人民共和國國家衛生健康委員會官方網站. 2022中國衛生健康統計年鑒. 2022.
3. 崔洪瑞, 黃麗, 譚清立. WHO基本藥物清單與國家基本藥物目錄及醫保目錄中精神障礙藥物收錄情況比較. 中國藥物經濟學, 2023, 18(9): 26-31, 35.
4. 董途, 馬鑫, 馬姝麗, 等. WHO兒童基本藥物示范目錄、WHO和我國基本藥物目錄中抗感染藥物的比較與啟示. 中國藥房, 2023, 34(11): 1293-1297.
5. 劉博, 宋欽, 王雪, 等. 《國家基本藥物目錄》(2012年版和2018年版)與《世界衛生組織基本藥物標準清單》(2023版)中眼科用藥的比較和分析. 中南藥學, 2024, 22(7): 1934-1938.
6. 唐曉章, 譚娟, 李艷艷, 等. 現行《世界衛生組織基本藥物標準清單》《國家基本藥物目錄》收錄呼吸系統藥物對比分析. 中國藥業, 2023, 32(18): 29-33.
7. World Health Organization. The WHO model lists of essential medicines. 2023.
8. 國家衛生健康委員會. 國家基本藥物目錄: 2018版. 2018.
9. 國家醫保信息業務編碼標準數據庫動態維護. ICD-10醫保版. 2023.
10. 張玉. 全國高級衛生專業技術資格考試指導: 醫院藥學. 北京: 人民衛生出版社, 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. 薛慧穎, 李娟. 解讀2018年版《國家基本藥物目錄》. 醫藥導報, 2019, 38(1): 1-8.
14. 胡盛壽, 高潤霖, 劉力生, 等. 《中國心血管病報告2018》概要. 中國循環雜志, 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): CD012282.
21. 楊琛. 氟伐他汀緩釋片有效性與安全性的研究進展. 藥品評價, 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. 張希龍. 高血壓治療的研究進展. 中國城鄉企業衛生, 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. 陳靈芝, 王慶廣, 杜春艷, 等. 替格瑞洛改善大動脈粥樣硬化性腦梗死患者氯吡格雷抵抗的研究. 中國醫刊, 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. 徐榮彬, 楊俊, 韓晟, 等. 吲哚布芬預防心腦血管事件效果和安全性的Meta分析. 中國循證心血管醫學雜志, 2017, 9(5): 532-538.
31. 丁香園. 中國缺血性腦卒中血脂管理指導規范. 實用心腦肺血管病雜志, 2015, (4): 117-117.
32. National Institute for Health and Clinical Excellence. Acute coronary syndromes. 2020.
33. 中華醫學會, 中華醫學會臨床藥學分會, 中華醫學會雜志社, 等. ST段抬高型心肌梗死基層合理用藥指南. 中華全科醫師雜志, 2021, 20(4): 397-409.
34. 中華醫學會, 中華醫學會臨床藥學分會, 中華醫學會雜志社, 等. 穩定性冠心病基層合理用藥指南. 中華全科醫師雜志, 2021, 20(4): 423-434.
35. 中華醫學會, 中華醫學會臨床藥學分會, 中華醫學會雜志社, 等. 冠心病心臟康復基層合理用藥指南. 中華全科醫師雜志, 2021, 20(3): 311-320.
36. 中華醫學會, 中華醫學會雜志社, 中華醫學會全科醫學分會, 等. 穩定性冠心病基層診療指南(2020年). 中華全科醫師雜志, 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. 國家衛生健康委, 國家發展改革委, 國家工業信息化部, 等. 關于印發國家基本藥物目錄管理辦法的通知(國衛藥政發). 2015.
41. 韓雨倍, 劉文臣, 陳琛, 等. 2023年版WHO基本藥物示范目錄特點分析及啟示. 中國衛生政策研究, 2024, 17(2): 53-58.

Chinese Journal of Evidence-Based Medicine

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

Abstract Full text Figures/Tables Video References Cited by

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