Persistence in drug therapy of hypertension among different treatment groups and comparison between fixed-dose combinations of ara ii + calcium channel blockers vs ace inhibitors + calcium channel blockers
DOI:
https://doi.org/10.31053/1853.0605.v69.n4.20883Abstract
High blood pressure (HBP) is a prevalent and chronic disease, requiring pharmacologic and nonpharmacologic sustainable treatment to achieve control. "Persistence" is the continuity of pharmacological treatments. Knowing the persistence of antihypertensive therapy groups could help prioritize those with better results. The aim is to describe the persistence to antihypertensive therapy in a cohort of patients using different methods and compare the persistence of different pharmacological groups used for hypertension treatment.Materials and Methods
Observational, retrospective cohort using secondary databases obtained during drug dispensing and electronic hospital records from the Hospital Italiano de Buenos Aires. Adult population with diagnosed hypertension and monitoring for two years.
Results
Diuretics, beta-blockers and first generation of angiotensin converting enzyme are the groups with the largest fall in persistence. Angiotensin antagonists in monotherapy or in combination with beta-blockers and diuretic second generation showed the best results of persistence. Persistence never reached 60% at 2 years.
Conclusion
Despite having measure persistence through different methods the results were similar and showed low persistence to antihypertensive therapy. We found no pharmacological extra variables that could explain the persistence in different therapeutic groups.
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References
JAMA. 1991;265:3255-3264. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the ElderlyProgram.
JAMA. 2002;288:2981-2997. Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT offi cers and coordinators for the ALLHAT collaborative research group. The antihypertensive and lipid-lowering treatment to prevent heart attack trail.
Lancet. 2003;362:1527-1535. Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascularevents: results of prospectively-designed overview of randomized trials.
J Invest Med. 2003;51:373-385.Egan BM, Basile JN. Controlling blood pressure in 50% of all hypertensive patients: an achievable goal in the healthy people 2010 report?
Clin Ther. 2006 Sep;28(9):1411-24. Toward a standard definition and measurement of persistence with drug therapy: Examples from research on statin and antihypertensive utilization.
Who - Adherence to long-term therapies: Evidence for action. 2003. ultima visita 25 marzo 2012. http://apps.who.int/medicinedocs/en/d/Js4883e/
Med J Aust. 2008 Feb 18;188(4):224-7. Persistence with antihypertensive medication: Australia-wide experience, 2004-2006.
BMC Fam Pract. 2008 Nov 6;9:61. Improved persistence and adherence to diuretic fixed-dose combination therapy compared to diuretic monotherapy.
Clin Drug Investig. 2008;28(11):713-34. Using fixed-dose combination therapies to achieve blood pressure goals.
Am J Cardiovasc Drugs. 2007;7(6):413-22. Fixed-dose combination antihypertensives and reduction in target organ damage: are they all the same?
Clin Drug Investig. 2010;30(9):625-41. doi: 10.2165/11538440-000000000-00000. Efficacy of fixed-dose combination therapy in the treatment of patients with hypertension: focus on amlodipine/valsartan.
Clin Ther. 2006;28:1411-1424. Toward a standard definition and measurement of persistence with drug therapy.
Ann Pharmacother. 2006 Jul-Aug;40(7-8):1280-88. Measuring Prescription Adherence for Pharmaceutical Prescription Refills.
Am J Manag Care. 2005 Jul;11(7):449-57. Estimating Medication Persistency Using Administrative Claims Data.
2001. InfoSUIS, 2001(11): p.4-7. Desarrollo e implementación de un Sistema de Prescripción Electrónica.
2001. InfoSUIS, 2001(10): p. 3-6. Sistemas de Prescripción Electrónica
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