[PP.01.01] ANTIHYPERTENSIVE TREATMENT IN ROUTINE CLINICAL PRACTICE OF SPECIALIZED CARDIOLOGICAL CENTRE: SIX-YEAR TRENDS. (September 2017)

• Record Type: Journal Article
• Authors: Zvartau, N.; Krikunov, A.; Semakova, A.; Bolgova, E.; Kovalchuk, S.; Boukhanovsky, A.; Konradi, A.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523214.95991.6d
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Guidelines describe algorithms on how to manage high blood pressure; however there is lack of information on true feasibility and impact on routine clinical practice. The main objective of this study was to assess prescribed in real life practice antihypertensive treatment and six-year trends in adult hypertensive patients referred to specialized cardiology clinic. Design and method: Data included 68276 (24183 males and 43913 females) electronic records of patients, mean age 58.3Y[REPLACEMENT CHARACTER]Y13, 8 years, referred due to uncontrolled hypertension (HTN). Descriptive statistics were used to estimate the means in gender, age [under 35 years (nY=Y4665), 35-49 (nY=Y9774), 50-65 (nY=Y29682), older than 65 (nY=Y24155) years] and antihypertensive drug classes (AHD) and severity of HTN [1 (nY=Y3973), 2 (nY=Y30629) and 3 degree (nY=Y20239)] subgroups. Linear regression was employed to determine the yearly trends. Age and gender-specific results were adjusted to Saint-Petersburg general population data for 6-years period and every studied year. Results: The mean number of prescribed AHD per patients constituted 1, 93. There was a 20, 1% increase in mean number of AHD during 2010-2013 (R 2 Y=Y0, 99; pY=Y0, 001) with subsequent decrease by 21, 2% from 2013 till 2015 (R 2 Y=Y0, 98; pY=Y0, 01), mostly due to subgroups with more severe HTN. The most frequently prescribed AHD classes were beta-blockers (BB; 30734 cases, 45%), angiotensin receptor blockers (ARB; 19474, 28%), calcium channel blockers (CCB; 17752, 26%), ACE inhibitors (ACEi; 15178, 22%). Monotherapy was prescribed up to 20% (13691), 64% constituted ARB and ACEi. Two-drugs combinations were used by 20% (13880) of patients, the top were ARBY+YCCB (15, 1%) and ARBY+YBB (12, 8%). Three-drugs combinations were taken by 19% (13407) of patients and the leaders were diuretic (D)Y+YBBY+YARB (13, 4%) orY+YACEi (12, 9%). Interestingly, women demand at least 2 AHD (2, 03), while 13% of males used monotherapy mostly with ACEi (nY=Y1532) or ARB (nY=Y1499). There were no substantial yearly trends in AHD classes in overall population and specified subgroups. Conclusions: Results demonstrated that real-life practice is sometimes far away from recommended pathways. This may be explained by a specific population of specialized center with numerous concomitant cardiovascular and other diseases forcing to step away from optimal approach.