Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice

Aim. To study the pharmacoepidemiological features of the prescription of antihypertensive fixed dose combinations and their efficacy in hypertensive patients in the real outpatient practice in Vladivostok city.Material and methods. Hypertensive patients aged 1 8 years and older (n=268) observed in...

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Main Authors: E. V. Yakukhnaya, E. V. Solyanik, V. V. Khitrina, Yu. V. Kuznetsova
Format: Article
Language:English
Published: Столичная издательская компания 2019-05-01
Series:Рациональная фармакотерапия в кардиологии
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Online Access:https://www.rpcardio.online/jour/article/view/1912
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author E. V. Yakukhnaya
E. V. Solyanik
V. V. Khitrina
Yu. V. Kuznetsova
author_facet E. V. Yakukhnaya
E. V. Solyanik
V. V. Khitrina
Yu. V. Kuznetsova
author_sort E. V. Yakukhnaya
collection DOAJ
description Aim. To study the pharmacoepidemiological features of the prescription of antihypertensive fixed dose combinations and their efficacy in hypertensive patients in the real outpatient practice in Vladivostok city.Material and methods. Hypertensive patients aged 1 8 years and older (n=268) observed in Vladivostok polyclinics from October to December 2017 were included into the study. All patients did not have target blood pressure (BP) levels. The analysis of the medical prescriptions of antihypertensive fixed dose combinations in Vladivostok polyclinics was performed. Two-component (perindopril + amlodipine) or three-component (perindopril + amlodipine + indapamide) fixed dose combinations were prescribed by physician in accordance with instructions for medical use and their pharmacological characteristics. The study was non-interventional and included 3 visits for the initial examination, prescription and correction of therapy, considering its efficacy. All patients were determined for glomerular filtration rate using CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Formula), changes in BP. Patients performed self-esteem on a 1 0-point visual analogue scale (VAS).Results. Only 23.4% of patients reached target BP levels in the first month of observation, and 84.5% of patients after 3 months of observation. 30 (1 1.2%) patients had replacement with double antihypertensive fixed dose to triple combination combinations during the study. 68.6% of patients did not have a replacement for the initial prescribed antihypertensive fixed dose combinations due to the achievement of target BP. The number of patients with moderately and markedly reduced glomerular filtration rate was reduced significantly. Initially, the patients included into the study assessed health (according to adapted VAS) for 5.6±1.4 points, and after 3 months of follow-up - for 7.9±1.7 points.Conclusion. The use of antihypertensive fixed dose combinations containing ACE inhibitor (perindopril), calcium channel blocker (amlodipine) and thiazide-like diuretic (indapamide) resulted in achievement of target BP levels in 84.5% of patients after 3 months of follow-up. Also, the use of double and triple fixed dose combinations had a nephroprotective effect, manifested in an increase in the number of patients ( + 19.3%) with a glomerular filtration rate more than 60 ml/min/1,73м2 and a positive effect on the patient's well-being.
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series Рациональная фармакотерапия в кардиологии
spelling doaj-art-65786d8acedb4deaa2df25b4a42ce0822025-08-23T10:00:30ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532019-05-0115219119710.20996/1819-6446-2019-15-2-191-1971594Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory PracticeE. V. Yakukhnaya0E. V. Solyanik1V. V. Khitrina2Yu. V. Kuznetsova3Pacific State Medical University; Far Eastern District Medical Center, Federal Medical-Biological Agency of RussiaPacific State Medical UniversityPacific State Medical UniversityFar Eastern District Medical Center, Federal Medical-Biological Agency of RussiaAim. To study the pharmacoepidemiological features of the prescription of antihypertensive fixed dose combinations and their efficacy in hypertensive patients in the real outpatient practice in Vladivostok city.Material and methods. Hypertensive patients aged 1 8 years and older (n=268) observed in Vladivostok polyclinics from October to December 2017 were included into the study. All patients did not have target blood pressure (BP) levels. The analysis of the medical prescriptions of antihypertensive fixed dose combinations in Vladivostok polyclinics was performed. Two-component (perindopril + amlodipine) or three-component (perindopril + amlodipine + indapamide) fixed dose combinations were prescribed by physician in accordance with instructions for medical use and their pharmacological characteristics. The study was non-interventional and included 3 visits for the initial examination, prescription and correction of therapy, considering its efficacy. All patients were determined for glomerular filtration rate using CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration Formula), changes in BP. Patients performed self-esteem on a 1 0-point visual analogue scale (VAS).Results. Only 23.4% of patients reached target BP levels in the first month of observation, and 84.5% of patients after 3 months of observation. 30 (1 1.2%) patients had replacement with double antihypertensive fixed dose to triple combination combinations during the study. 68.6% of patients did not have a replacement for the initial prescribed antihypertensive fixed dose combinations due to the achievement of target BP. The number of patients with moderately and markedly reduced glomerular filtration rate was reduced significantly. Initially, the patients included into the study assessed health (according to adapted VAS) for 5.6±1.4 points, and after 3 months of follow-up - for 7.9±1.7 points.Conclusion. The use of antihypertensive fixed dose combinations containing ACE inhibitor (perindopril), calcium channel blocker (amlodipine) and thiazide-like diuretic (indapamide) resulted in achievement of target BP levels in 84.5% of patients after 3 months of follow-up. Also, the use of double and triple fixed dose combinations had a nephroprotective effect, manifested in an increase in the number of patients ( + 19.3%) with a glomerular filtration rate more than 60 ml/min/1,73м2 and a positive effect on the patient's well-being.https://www.rpcardio.online/jour/article/view/1912antihypertensive therapyfixed combinationtarget blood pressurechronic kidney disease
spellingShingle E. V. Yakukhnaya
E. V. Solyanik
V. V. Khitrina
Yu. V. Kuznetsova
Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice
Рациональная фармакотерапия в кардиологии
antihypertensive therapy
fixed combination
target blood pressure
chronic kidney disease
title Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice
title_full Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice
title_fullStr Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice
title_full_unstemmed Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice
title_short Pharmacoepidemiological Research of the Efficacy of Fixed Dose Combinations in the Treatment of Patients with Arterial Hypertension in Ambulatory Practice
title_sort pharmacoepidemiological research of the efficacy of fixed dose combinations in the treatment of patients with arterial hypertension in ambulatory practice
topic antihypertensive therapy
fixed combination
target blood pressure
chronic kidney disease
url https://www.rpcardio.online/jour/article/view/1912
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AT evsolyanik pharmacoepidemiologicalresearchoftheefficacyoffixeddosecombinationsinthetreatmentofpatientswitharterialhypertensioninambulatorypractice
AT vvkhitrina pharmacoepidemiologicalresearchoftheefficacyoffixeddosecombinationsinthetreatmentofpatientswitharterialhypertensioninambulatorypractice
AT yuvkuznetsova pharmacoepidemiologicalresearchoftheefficacyoffixeddosecombinationsinthetreatmentofpatientswitharterialhypertensioninambulatorypractice