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Inicio Medicina Clínica (English Edition) Control of blood pressure in hypertensive patients on combination therapy
Journal Information
Vol. 144. Issue 4.
Pages 145-150 (February 2015)
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Vol. 144. Issue 4.
Pages 145-150 (February 2015)
Original article
DOI: 10.1016/j.medcle.2015.05.013
Control of blood pressure in hypertensive patients on combination therapy
Control de la presión arterial en pacientes en tratamiento con terapia combinada
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Alejandro de la Sierraa,
Corresponding author
adelasierra@mutuaterrassa.es

Corresponding author.
, Anna Oliverasb, Pedro Armarioc, Silvia Lucasd, on behalf of the investigators of the COMBICONTROL study
a Servicio de Medicina Interna, Hospital Mutua Terrassa, Universidad de Barcelona, Barcelona, Spain
b Servicio de Nefrología, Hospital del Mar, Barcelona, Spain
c Área de Enfermedades Cardiovasculares, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
d Departamento Médico, Menarini, Barcelona, Spain
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Figures (1)
Tables (3)
Table 1. General characteristics of the series.
Table 2. Clinical differences among patients with controlled blood pressure figures (<140/90mmHg) and non-controlled patients.
Table 3. Most commonly used antihypertensive drug groups.
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Abstract
Background and aim

The impact of antihypertensive treatment on blood pressure (BP) control is fairly unknown. The aim of the study was to evaluate the degree of BP control and its relationship with treatment-related factors in hypertensive patients treated with two or three agents and attended in referral units.

Patients and methods

We studied 1337 hypertensive subjects (41% women) with a mean age (SD) of 63 (12) years, who were receiving two or three antihypertensive drugs. The degree of BP control was estimated in a single visit by the proportion of patients with BP below 140/90mmHg.

Results

BP was controlled in 767 patients (57%). Lack of BP control was related to older age (12% risk for each 10-year increase) and the presence of microalbuminuria (64% risk increase). In those treated with two agents, BP control was 61%, without differences between those treated with fixed-drug or free combinations. BP control in those treated with three agents was 55%, higher in those receiving three agents in a fixed-drug combination (68%) compared with those on three agents administered separately (52%; p=0.025). Drug classes used in combinations did not influence the degree of BP control.

Conclusions

The degree of BP control in patients treated with two or three agents is 57%. Microalbuminuria is related to a lack of BP control. In those receiving three agents, the use of fixed-drug combinations is associated with better BP control.

Keywords:
Hypertension
Blood pressure control
Microalbuminuria
Drug combinations
Resumen
Fundamento y objetivo

El impacto del tratamiento antihipertensivo sobre el control de la presión arterial (PA) es poco conocido. El objetivo del estudio ha sido examinar el grado de control de la PA y su relación con aspectos derivados del tratamiento en hipertensos tratados con 2 o 3 fármacos y atendidos en unidades hospitalarias.

Pacientes y método

Se han estudiado 1.337 hipertensos (41% mujeres) con una edad media (DE) de 63 (12) años, en tratamiento con 2 o 3 fármacos antihipertensivos. El grado de control se ha estimado en una única visita, calculando la proporción de pacientes con cifras inferiores a 140/90mmHg.

Resultados

Un total de 767 pacientes (57%) tenían las cifras de PA controladas. El riesgo de mal control tensional se incrementaba con la edad (12% para cada 10 años) y con la presencia de oligoalbuminuria (64% de incremento). En los tratados con 2 fármacos, el grado de control fue del 61%, sin diferencias entre combinaciones fijas o libres. Los tratados con 3 fármacos presentaban tasas de control del 55%, mayores en los que recibían una asociación fija de los 3 antihipertensivos (68%) frente a los 3 fármacos por separado (52%; p=0,025). Los principios farmacológicos utilizados en las combinaciones no influyeron en el grado de control.

Conclusiones

El 57% de los pacientes en tratamiento con 2 o 3 antihipertensivos tiene sus cifras de presión controladas. La presencia de oligoalbuminuria se asocia al mal control. En los tratados con 3 fármacos, la utilización de asociaciones fijas se asocia con mayor control.

Palabras clave:
Hipertensión arterial
Control de la presión arterial
Oligoalbuminuria
Asociaciones farmacológicas

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