PCV15 BLOOD PRESSURE GOAL ACHIEVEMENT AMONG HYPERTENSION PATIENTS TREATED WITH VALSARTAN-BASED SINGLE PILL COMBINATION VS. ARB-BASED FREE COMBINATION IN SOUTH CENTRAL REGION

(1) Background: The present study aimed to assess the changes in blood pressure (BP) within the first 6 months of treatment initiation in a newly treated hypertensive cohort and to identify the factors that are associated with achieving the target BP recommended by the American (ACC/AHA, 2017), European (ESC/ESH, 2018), United Kingdom (NICE, 2019), and International Society of Hypertension (ISH, 2020) guidelines. (2) Methods: We analyzed 5308 incident hypertensive outpatients across Abu Dhabi, United Arab Emirates (UAE), in 2017; each patient was followed up for 6 months. Hypertension was defined as a BP of 130/80 mmHg according to the ACC/AHA guidelines and 140/90 mmHg according to the ESC/ESH, NICE, and ISH guidelines. Multiple logistic regression was used to identify factors associated with achieving the guideline-recommended BP targets. (3) Results: At baseline, the mean BP was 133.9 ± 72.9 mmHg and 132.7 ± 72.5 mmHg at 6 months. The guideline-recommended BP targets were 39.5%, 43%, 65.6%, and 40.8%, according to the ACC/AHA, ESC/ESH, NICE, and ISH guidelines, respectively. A BMI of <25 kg/m2 was associated with better BP control according to the ACC/AHA (odds ratio (OR) = 1.26; 95% confidence interval (CI) = 1.07–1.49), ESC/ESH (OR = 1.27; 95% CI = 1.08–1.50), and ISH guidelines (OR = 1.22; 95% CI = 1.03–1.44). Hypertension treated in secondary care settings was more likely to achieve the BP targets recommended by the ACC/AHA (1.31 times), ESC/ESH (1.32 times), NICE (1.41 times), and ISH (1.34 times) guidelines. (4) Conclusions: BP goal achievement was suboptimal. BP control efforts should prioritize improving cardiometabolic goals and lifestyle modifications.

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Adherence to prescription guidelines and achievement of treatment goals among persons with coronary heart disease in Tromsø 7

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01866-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elisabeth Pedersen ◽

Beate Hennie Garcia ◽

Kjell H. Halvorsen ◽

Anne Elise Eggen ◽

Henrik Schirmer ◽

...

Keyword(s):

Blood Pressure ◽

Coronary Heart Disease ◽

Heart Disease ◽

Clinical Practice ◽

Ldl Cholesterol ◽

Antihypertensive Drugs ◽

Goal Achievement ◽

Treatment Goal ◽

Blood Pressure Goal ◽

Treatment Goals

Abstract Background Adherence to clinical practice guidelines for coronary heart disease (CHD) reduces morbidity, mortality and treatment costs. We aimed to describe and compare adherence to prescription guidelines for persons with CHD, and explore its association with treatment goal achievement. Method We included all participants reporting myocardial infarction, angina, percutaneous coronary intervention and/or coronary artery bypass surgery in the seventh wave of the Tromsø Study (2015–2016, n = 1483). Medication use and treatment goal measures (blood pressure, low-density lipoprotein (LDL)-cholesterol and HbA1c) were compared to clinical practice guidelines on secondary CHD prevention. Propensity score matched logistic regression was used to assess the association between the use of antihypertensive drugs and achievement of treatment goal for blood pressure, and the use of lipid-lowering drugs (LLDs) and achievement of treatment goal for LDL-cholesterol. Results The prevalence of pharmacological CHD treatment was 76% for LLDs, 72% for antihypertensive drugs and 66% for acetylsalicylic acid. The blood pressure goal (< 140/90 mmHg, < 140/80 mmHg if diabetic) was achieved by 58% and the LDL-cholesterol goal (< 1.8 mmol/l or < 70 mg/dL) by 9%. There was a strong association between using LLDs and achieving the treatment goal for LDL-cholesterol (OR 14.0, 95% CI 3.6–54.7), but not between using antihypertensive drugs and blood pressure goal achievement (OR 1.4, 95% CI 0.7–2.7). Conclusion Treatment goal achievement of LDL-cholesterol and blood pressure was low, despite the relatively high use of LLDs and antihypertensive drugs. Further research is needed to find the proper actions to increase achievement of the treatment goals.

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Abstract 306: China Observational Study on Efficacy and Safety of Valsartan/Amlodipine Single-Pill Combination in Treating Patients with Blood Pressure Uncontrolled by Monotherapy (China STATUS II): Interim Analysis

Hypertension ◽

10.1161/hyp.60.suppl_1.a306 ◽

2012 ◽

Vol 60 (suppl_1) ◽

Author(s):

Dayi Hu ◽

Lisheng Liu ◽

Weimin Li

Keyword(s):

Blood Pressure ◽

Adverse Events ◽

Observational Study ◽

Interim Analysis ◽

Chinese Patients ◽

Blood Pressure Goal ◽

Efficacy And Safety ◽

Hypertensive Patients ◽

Single Pill ◽

Trial Drug

BACKGROUND Single-pill combination (SPC) in hypertension treatment has been recommended in guidelines for its benefits on improving blood pressure (BP) control and reducing adverse events (AEs) by simplifying treatment. OBJECTIVE To evaluate efficacy and safety of valsartan/amlodipine SPC on BP control in Chinese hypertensive patients in a real-life practice setting. METHODS This is a multicenter, open-label, observational study in Chinese hypertensive patients. Adults (18 and older) who were not at BP goal (<140/90 mmHg for uncomplicated patients, and <130/80 mmHg for patients with diabetes and chronic kidney disease) on monotherapy were eligible to the study. Patients were treated with valsartan/amlodipine 80/5 mg SPC and were followed over 8 weeks with approximately monthly intervals between clinic visits. For patients not achieving BP goal at week 4, other antihypertensives might be added. RESULTS A total of 11,879 patients were recruited into the study. In this interim analysis (from October 12, 2010 to October 11, 2011), a total of 4,609 patients were included. Among them, 39 were excluded due to violation of inclusion criteria, 20 discontinued (9 due to AEs). In total, 4,562 were included in the analysis. Mean age was 57.6 years, 7.1% (324 of 4562) of patients aged ≥80. Overall, mean BP was reduced from 159.7/95.6 mmHg at baseline to 132.0/80.3 mmHg at week 8 (-27.7/-15.3 mmHg, P<0.0001). The magnitude of BP reduction increased by severity of baseline BP. Blood pressure goal was achieved in 67.4% (3076 of 4562) of patients. In patients aged 80 or over, 65.1% (211 of 324) achieved BP goal. Add-on antihypertensives were prescribed in 6.2% (283 of 4562) of patients with diuretics the most often used. Adverse events were reported in 2.2% (99 of 4604) of patients. Edema was reported in 12 patients (0.3%). Three patients experienced serious AEs, of which none were trial drug related. In patients aged ≥80, AEs were reported in 1.2% (4 of 327) of patients, with 2 trial drug related AEs (0.61%), 1 of hypotension and 1 of flush. CONCLUSION In this 1 st largest observational study in Chinese hypertensive patients, the interim analysis results showed that valsartan/amlodipine SPC was effective and safe on BP control in Chinese patients, as well as in patients aged 80 and over.

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