Background Evidence on recent time trends in age-gender differences in cardiovascular drug use is scarce. We studied time trends in age-gender-specific cardiovascular drug use for primary prevention, in-hospital treatment and secondary prevention of CHD.

Methods The PHARMO database network was used for record linkage of drug dispensing, hospitalisation and population data to identify drug use between 1998 and 2010 in 1,206,469 persons ≥25 years eligible for primary prevention, 84,621 persons hospitalised for an acute coronary syndrome (ACS) and 15,651 persons eligible for secondary prevention.

Results Between 2003 and 2010, the proportion of women that used lipid lowering drugs for primary prevention was lower compared with the proportion of men (5.8% vs. 7.4% in 2010, P < 0.001). The higher proportion of women that used blood pressure lowering drugs in primary prevention, compared to men, attenuated over time (P < 0.001, 14.1% vs. 15.3% in 2010). During hospital admission for an ACS, the proportion of women that used cardiovascular drugs was lower compared to men. In long-term secondary prevention (36 months after hospital discharge) for ACS patients, drug use was lowest in young women. The proportion receiving lipid lowering drugs declined after the age of 75. This age difference attenuated over time (P < 0.001), however a marked decline in lipid lowering drug use after age 85 years remained in all three settings.

Conclusion The use of cardiovascular drugs for in-hospital treatment, primary and secondary prevention of CHD increased in recent years in the Netherlands. Age differences in drug use tended to attenuate over time, while gender differences persisted.