[PP.02.01] SIX-YEAR TRENDS IN ANTYHYPERTENSIVE MONOTHERAPY AND BLOOD PRESSURE CONTROL IN PATIENTS REFERRED TO SPECIALIZED CARDIOLOGICAL CENTRE. (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.0000523243.04508.3b
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Hypertension monotherapy is considered to be effective in 10–20% of patients with mild or mild-to-moderate hypertension (HTN). However latest evidence suggest sometimes a dramatic difference in efficacy and even safety of different members of an antihypertensive drug (AD) class. These may have an impact on response rate, blood pressure control, adherence and physician preferences concerning choice of precise AD for monotherapy. The main objective of this study was to describe trends in choice of antihypertensive monotherapy and blood pressure control in adult hypertensive patients referred to specialized cardiology clinic during the six-year period. Design and method: We extracted 13691 monotherapy data from 68276 electronic medical records of patients referred to specialized cardiology clinic due to uncontrolled or therapy-naive HTN during the period of January 2010 - December 2015. Descriptive statistics were used to estimate the means, linear regression was employed to determine the yearly trends. Results: Overall, ACE inhibitors (ACEi) and angiotensin II receptors antagonists (ARA) remained the most commonly used antihypertensive drug classes [4326 patients (31, 6%) and 4504 patients (32, 9%), respectively] without significant 6-year trends. Approximately 16.6% of hypertensive adults were taking beta-blockers (2273 patients) and 11, 8% (1616 patients) calcium channel blockers (CCBs), the use of these classes remained relatively constant during the survey period. Interestingly, diuretics were the less commonly used drug class without significant changes during 6-year period (7, 1%, 972 patients). Perindopril (41, 6%) and Enalapril (20, 7%) were the most commonly used ACEi during studied period. Among other classes the leaders were Metoprolol (57, %) and Bisoprolol (20.7%) for beta-blockers; Losartan (52, 9%) and Valsartan (37, 5%) for ARA; Amlodipine (88, 5%) and Nifedipine (6, 6%) for CCB and Indapamide (85, 3%) and Hydrochlorotiazide (6, 6%) for diuretics without significant six-year trends. Blood pressure control rate on monotherapy was approximately 31% during studied period without significant 6-year trends. However monotherapy with ACEi and ARA provided better blood pressure control up to 35% compared to 27% on diuretics. Conclusions: RAAS blockers are the most frequently used and effective classes for monotherapy of HTN. The choice of a precise member of an antihypertensive drug may have an impact on monotherapy success rate.