Combination antihypertensive therapy in clinical practice. The analysis of 1254 consecutive patients with uncontrolled hypertension
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
25833703
DOI
10.1038/jhh.2015.24
PII: jhh201524
Knihovny.cz E-zdroje
- MeSH
- antihypertenziva terapeutické užití MeSH
- hypertenze farmakoterapie MeSH
- kombinovaná farmakoterapie MeSH
- lékařská praxe - způsoby provádění statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- antihypertenziva MeSH
The aim of the study was to analyze the clinical use of different types of combination therapy in a large sample of consecutive patients with uncontrolled hypertension referred to Hypertension Centre. We performed a retrospective analysis of combination antihypertensive therapy in 1254 consecutive patients with uncontrolled hypertension receiving at least triple-combination antihypertensive therapy. Among the most prescribed antihypertensive classes were renin-angiotensin blockers (96.8%), calcium channel blockers (82.5%), diuretics (82.0%), beta-blockers (73.0%), centrally acting drugs (56.0%) and urapidil (24.1%). Least prescribed were spironolactone (22.2%) and alpha-1-blockers (17.1%). Thiazide/thiazide-like diuretics were underdosed in more than two-thirds of patients. Furosemide was prescribed in 14.3% of patients treated with diuretics, while only indicated in 3.9%. Inappropriate combination therapy was found in 40.4% of patients. Controversial dual and higher blockade of renin-angiotensin system occurred in 25.2%. Incorrect use of a combination of two antihypertensive drugs with the similar mechanism of action was found in 28.1%, most commonly a combination of two drugs with central mechanism (13.5%). In conclusion, use of controversial or incorrect combinations of drugs in uncontrolled hypertension is common. Diuretics are frequently underdosed and spironolactone remains neglected in general practice. The improper combination of antihypertensive drugs may contribute to uncontrolled hypertension.
Zobrazit více v PubMed
Hypertension. 2008 Jun;51(6):1403-19 PubMed
Hypertens Res. 2008 Jan;31(1):59-67 PubMed
Am J Kidney Dis. 2008 Sep;52(3):486-93 PubMed
Hypertension. 2011 Jun;57(6):1069-75 PubMed
JAMA. 2000 Apr 19;283(15):1967-75 PubMed
Circulation. 2008 Jul 1;118(1):42-8 PubMed
J Hum Hypertens. 2003 May;17(5):349-52 PubMed
N Engl J Med. 2009 Nov 26;361(22):2153-64 PubMed
J Am Coll Cardiol. 2010 Nov 2;56(19):1527-34 PubMed
Hypertens Res. 2013 Dec;36(12):1051-9 PubMed
J Hypertens. 2007 Sep;25(9):1751-62 PubMed
J Hypertens. 2010 Nov;28(11):2329-35 PubMed
Clin Pharmacokinet. 1996 Mar;30(3):229-49 PubMed
N Engl J Med. 2012 Dec 6;367(23):2204-13 PubMed
Lancet. 2008 Aug 16;372(9638):547-53 PubMed
Hypertension. 2011 Dec;58(6):1008-13 PubMed
J Hypertens. 2013 Jul;31(7):1281-357 PubMed
J Hypertens. 2010 Nov;28(11):2196-203 PubMed
BMJ Open. 2013 Aug 30;3(8):e003423 PubMed
Hypertension. 2010 Jan;55(1):147-52 PubMed
Eur J Cardiovasc Prev Rehabil. 2010 Oct;17(5):530-40 PubMed
J Hypertens. 2012 Aug;30(8):1656-64 PubMed
J Hum Hypertens. 2014 Nov;28(11):684-8 PubMed
Hypertension. 2011 Jun;57(6):1076-80 PubMed
N Engl J Med. 2013 Nov 14;369(20):1892-903 PubMed
Adv Ther. 2010 Jul;27(7):426-43 PubMed
J Clin Hypertens (Greenwich). 2006 Mar;8(3):159-66; quiz 167-8 PubMed
J Hypertens. 2009 Nov;27(11):2121-58 PubMed
Hypertension. 2007 Apr;49(4):839-45 PubMed
Should All Patients with Resistant Hypertension Receive Spironolactone?
