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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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Systolic blood pressure decrease over 24 months in the selected population of patients allocated to different drug classes and not replacing the antihypertensive treatment after withdrawal.*p < 0.05 vs other drug classes.Abbreviations: ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin-II receptor blockers; CCBs, calcium channel blockers.
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fig3: Systolic blood pressure decrease over 24 months in the selected population of patients allocated to different drug classes and not replacing the antihypertensive treatment after withdrawal.*p < 0.05 vs other drug classes.Abbreviations: ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin-II receptor blockers; CCBs, calcium channel blockers.

Mentions: The decrease of SBP and DBP in response to treatment was largely proportional to the rate of persistence on treatment and greater in patients treated with ARBs, ACE inhibitors, and CCBs (Figure 2). The difference was clearly enhanced in those patients in whom the initial treatment was not replaced by a different antihypertensive drug after discontinuation (Figure 3). No ARB, ACE inhibitor, β-blocker, or diuretic was associated with a higher BP control compared with the other molecules used in each therapeutic class. The treatment with lercanidipine was associated with a trend toward a better BP control vs other CCBs with a difference that achieved a statistical significance after 24 months of treatment.


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)

Systolic blood pressure decrease over 24 months in the selected population of patients allocated to different drug classes and not replacing the antihypertensive treatment after withdrawal.*p < 0.05 vs other drug classes.Abbreviations: ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin-II receptor blockers; CCBs, calcium channel blockers.
© Copyright Policy
Related In: Results  -  Collection

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

fig3: Systolic blood pressure decrease over 24 months in the selected population of patients allocated to different drug classes and not replacing the antihypertensive treatment after withdrawal.*p < 0.05 vs other drug classes.Abbreviations: ACEIs, angiotensin-converting enzyme inhibitors; ARBs, angiotensin-II receptor blockers; CCBs, calcium channel blockers.
Mentions: The decrease of SBP and DBP in response to treatment was largely proportional to the rate of persistence on treatment and greater in patients treated with ARBs, ACE inhibitors, and CCBs (Figure 2). The difference was clearly enhanced in those patients in whom the initial treatment was not replaced by a different antihypertensive drug after discontinuation (Figure 3). No ARB, ACE inhibitor, β-blocker, or diuretic was associated with a higher BP control compared with the other molecules used in each therapeutic class. The treatment with lercanidipine was associated with a trend toward a better BP control vs other CCBs with a difference that achieved a statistical significance after 24 months of treatment.

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