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A prospective evaluation of persistence on antihypertensive treatment with different antihypertensive drugs in clinical practice.

Veronesi M, Cicero AF, Prandin MG, Dormi A, Cosentino E, Strocchi E, Borghi C - Vasc Health Risk Manag (2007)

Bottom Line: No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher persistence in therapy compared with the other molecules used in each therapeutic class.Systolic and diastolic BP was decreased more successfully in patients treated with ARBs (-11.2/-5.8 mmHg), ACE inhibitors (-10.5/-5.1 mmHg), and CCBs (-8.5/-4.6 mmHg) compared with beta-blockers (-4.0/-2.3 mmHg p < 0.05) and diuretics (-2.3/-2.1 mmHg, p < 0.05).No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher BP control compared with the other molecules used in each therapeutic class.

View Article: PubMed Central - PubMed

Affiliation: D. Campanacci Clinical Medicine and Applied Biotechnology Department, Alma Mater Studiorum University of Bologna, Italy.

ABSTRACT
Persistence on treatment affects the efficacy of antihypertensive treatment. We prospectively investigated the persistence on therapy and the extent of blood pressure (BP) control in 347 hypertensive patients (age 59.4 +/- 6 years) randomly allocated to a first-line treatment with: angiotensin-converting enzyme (ACE) inhibitors, calcium-channel blockers (CCBs), beta-blockers, angiotensin-II receptor blockers (ARBs), or diuretics and followed-up for 24-months. Persistence on treatment was higher in patients treated with ARBs (68.5%) and ACE inhibitors (64.5%) vs CCBs (51.6%; p < 0.05), beta-blockers (44.8%, p < 0.05), and diuretics (34.4%, p < 0.01). No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher persistence in therapy compared with the other molecules used in each therapeutic class. The rate of persistence was significantly higher in patients treated with lercanidipine vs others CCBs (59.3% vs 46.6%, p < 0.05). Systolic and diastolic BP was decreased more successfully in patients treated with ARBs (-11.2/-5.8 mmHg), ACE inhibitors (-10.5/-5.1 mmHg), and CCBs (-8.5/-4.6 mmHg) compared with beta-blockers (-4.0/-2.3 mmHg p < 0.05) and diuretics (-2.3/-2.1 mmHg, p < 0.05). No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher BP control compared with the other molecules used in each therapeutic class. A trend toward a better BP control was observed in response to lercanidipine vs other CCBs (p = 0.059). The present results confirm the importance of persistence on treatment for the management of hypertension in clinical practice.

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Rate of persistence on treatment after 6,12, and 24 months in different subgroups of patients treated with angiotension-II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), lercanidipine, ß-blockers, and diuretics. *, **, ***p < 0.05, 0.01, 0.005 vs ARBs.
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fig1: Rate of persistence on treatment after 6,12, and 24 months in different subgroups of patients treated with angiotension-II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), lercanidipine, ß-blockers, and diuretics. *, **, ***p < 0.05, 0.01, 0.005 vs ARBs.

Mentions: At 24 months, the percentage of subjects continuing their initial ARB (68.5%) and ACE inhibitor (61.5%) medication was higher than the percentage of those continuing the treatment with CCBs (51.6%; p < 0.05), β-blockers (48.8%, p < 0.05), and thiazide diuretics (34.4%, p < 0.01) (Figure 1). The main reason for drug discontinuation was the occurrence of adverse effects in over two-thirds of the population not achieving the primary end-point of persistence. The main duration of persistence with treatment was: 20.3 ± 9 months for ARBs, 18.7 ± 8 months for ACE inhibitors, 17.1 ± 9 months for CCBs, and 15.8 ± 8 and 14.1 ± 9 months for ß-blockers and thiazide diuretics, respectively (p < 0.005 for trend). No ARB, ACE inhibitor, β-blocker, or diuretic was associated with a higher persistence in therapy compared with the other molecules used in each therapeutic class. Among the subgroup of patients treated with CCBs the rate of stay-on-therapy was higher in those treated with lercanidipine (59.3% vs 46.6%, p < 0.05 vs others CCBs).


A prospective evaluation of persistence on antihypertensive treatment with different antihypertensive drugs in clinical practice.

Veronesi M, Cicero AF, Prandin MG, Dormi A, Cosentino E, Strocchi E, Borghi C - Vasc Health Risk Manag (2007)

Rate of persistence on treatment after 6,12, and 24 months in different subgroups of patients treated with angiotension-II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), lercanidipine, ß-blockers, and diuretics. *, **, ***p < 0.05, 0.01, 0.005 vs ARBs.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2350135&req=5

fig1: Rate of persistence on treatment after 6,12, and 24 months in different subgroups of patients treated with angiotension-II receptor blockers (ARBs), angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), lercanidipine, ß-blockers, and diuretics. *, **, ***p < 0.05, 0.01, 0.005 vs ARBs.
Mentions: At 24 months, the percentage of subjects continuing their initial ARB (68.5%) and ACE inhibitor (61.5%) medication was higher than the percentage of those continuing the treatment with CCBs (51.6%; p < 0.05), β-blockers (48.8%, p < 0.05), and thiazide diuretics (34.4%, p < 0.01) (Figure 1). The main reason for drug discontinuation was the occurrence of adverse effects in over two-thirds of the population not achieving the primary end-point of persistence. The main duration of persistence with treatment was: 20.3 ± 9 months for ARBs, 18.7 ± 8 months for ACE inhibitors, 17.1 ± 9 months for CCBs, and 15.8 ± 8 and 14.1 ± 9 months for ß-blockers and thiazide diuretics, respectively (p < 0.005 for trend). No ARB, ACE inhibitor, β-blocker, or diuretic was associated with a higher persistence in therapy compared with the other molecules used in each therapeutic class. Among the subgroup of patients treated with CCBs the rate of stay-on-therapy was higher in those treated with lercanidipine (59.3% vs 46.6%, p < 0.05 vs others CCBs).

Bottom Line: No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher persistence in therapy compared with the other molecules used in each therapeutic class.Systolic and diastolic BP was decreased more successfully in patients treated with ARBs (-11.2/-5.8 mmHg), ACE inhibitors (-10.5/-5.1 mmHg), and CCBs (-8.5/-4.6 mmHg) compared with beta-blockers (-4.0/-2.3 mmHg p < 0.05) and diuretics (-2.3/-2.1 mmHg, p < 0.05).No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher BP control compared with the other molecules used in each therapeutic class.

View Article: PubMed Central - PubMed

Affiliation: D. Campanacci Clinical Medicine and Applied Biotechnology Department, Alma Mater Studiorum University of Bologna, Italy.

ABSTRACT
Persistence on treatment affects the efficacy of antihypertensive treatment. We prospectively investigated the persistence on therapy and the extent of blood pressure (BP) control in 347 hypertensive patients (age 59.4 +/- 6 years) randomly allocated to a first-line treatment with: angiotensin-converting enzyme (ACE) inhibitors, calcium-channel blockers (CCBs), beta-blockers, angiotensin-II receptor blockers (ARBs), or diuretics and followed-up for 24-months. Persistence on treatment was higher in patients treated with ARBs (68.5%) and ACE inhibitors (64.5%) vs CCBs (51.6%; p < 0.05), beta-blockers (44.8%, p < 0.05), and diuretics (34.4%, p < 0.01). No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher persistence in therapy compared with the other molecules used in each therapeutic class. The rate of persistence was significantly higher in patients treated with lercanidipine vs others CCBs (59.3% vs 46.6%, p < 0.05). Systolic and diastolic BP was decreased more successfully in patients treated with ARBs (-11.2/-5.8 mmHg), ACE inhibitors (-10.5/-5.1 mmHg), and CCBs (-8.5/-4.6 mmHg) compared with beta-blockers (-4.0/-2.3 mmHg p < 0.05) and diuretics (-2.3/-2.1 mmHg, p < 0.05). No ARB, ACE inhibitor, beta-blocker, or diuretic was associated with a higher BP control compared with the other molecules used in each therapeutic class. A trend toward a better BP control was observed in response to lercanidipine vs other CCBs (p = 0.059). The present results confirm the importance of persistence on treatment for the management of hypertension in clinical practice.

Show MeSH
Related in: MedlinePlus