Anti-hypertensive Medication Analysis in A Medical Examination Center_West China Medical Journal

Authors：

 YANGHua , GUANHua , LUOMin , ZUOXiao-jiao , JIANGLi

Health Management Center, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

Keywords：

Cross-sectional survey; Medical examination; Hypertension; Medication

DOI：

10.7507/1002-0179.20150462

Video：

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Objective To investigate the use of anti-hypertensive drugs among hypertension patients in examination medical center. Method This was a cross-sectional survey. Data of 3 000 cases of medical examination center health records from December 2012 to December 2013 were sampled, and 1 310 patients with hypertension were screened for analysis of medication. Results In the 1 310 hypertension patients, 959 used antihypertensive drugs before, among whom 423 (44.11%) accepted only one anti-hypertensive drug and 536 (55.89%) accepted compound anti-hypertensive drugs or combined medicine. In patients of the previous kind, calcium channel blocker classes of antihypertensive drugs were used the most (n=244, 25.44%). Among the second kind of patients, 359 (37.43%) were treated with a two-compound drug or a combination of two drugs, and most of them used the combination of calcium channel blocker with angiotensin receptor blocker or calcium channel blocker with angiotensin converting enzyme inhibitor. Conclusions The current using of anti-hypertensive drug is in accordance with the recommendation of anti-hypertensive treatment guidelines in some way, but there are still some gaps between real clinical practice and guidelines.

Citation： YANGHua, GUANHua, LUOMin, ZUOXiao-jiao, JIANGLi. Anti-hypertensive Medication Analysis in A Medical Examination Center. West China Medical Journal, 2015, 30(9): 1609-1612. doi: 10.7507/1002-0179.20150462 Copy

1.	中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华高血压杂志, 2011, 19(8):701-743.
2.	Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension:the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2013, 34(28):2159-2219.
3.	James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults:report from the panel members appointed to the Eighth Joint National Committee (JNC 8)[J]. JAMA, 2014, 311(5):507-520.
4.	Sever P. New hypertension guidelines from the National Institute for Health and Clinical Excellence and the British Hypertension Society[J]. J Renin Angiotensin Aldosterone Syst, 2006, 7(2):61-63.
5.	刘国树. β-受体阻滞剂在高血压治疗中的争论再评价[J]. 中国药物应用与监测, 2011, 8(4):195-199.
6.	中华医学会心血管病学分会, 中华心血管病杂志编辑委员. β肾上腺素能受体阻滞剂在心血管疾病应用专家共识[J]. 中华心血管病杂志, 2009, 37(3):195-209.
7.	Panjabi S, Lacey M, Bancroft T, et al. Treatment adherence, clinical outcomes, and economics of triple-drug therapy in hypertensive patients[J]. J Am Soc Hypertens, 2013, 7(1):46-60.
8.	Baser O, Andrews LM, Wang L, et al. Comparison of real-world adherence, healthcare resource utilization and costs for newly initiated valsartan/amlodipine single-pill combination versus angiotensin receptor blocker/calcium channel blocker free-combination therapy[J]. J Med Econ, 2011, 14(5):576-583.
9.	Bangalore S, Kamalakkannan G, Parkar S, et al. Fixed-dose combinations improve medication compliance:a meta-analysis[J]. Am J Med, 2007, 120(8):713-719.
10.	ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic:the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)[J]. JAMA, 2002, 288(23):2981-2997.
11.	Turner RC, Cull CA, Frighi V, et al. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus:progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group[J]. JAMA, 1999, 281(21):2005-2012.
12.	Hovater MB, Jaimes EA. Optimizing combination therapy in the management of hypertension:the role of the aliskiren, amlodipine, and hydrochlorothiazide fixed combination[J]. Integr Blood Press Control, 2013, 6:59-67.
13.	Lacourcière Y, Poirier L, Hebert D, et al. Antihypertensive efficacy and tolerability of two fixed-dose combinations of valsartan and hydrochlorothiazide compared with valsartan monotherapy in patients with stage 2 or 3 systolic hypertension:an 8-week, randomized, double-blind, parallel-group trial[J]. Clin Ther, 2005, 27(7):1013-1021.
14.	Zhu DL, Gao PJ, Liu SW, et al. Efficacy and tolerability of a single-pill combination of telmisartan/hydrochlorothiazide 80/25 mg in Chinese and Korean patients with moderate to severe hypertension:a subgroup analysis of a randomized, double-blind, active-controlled trial[J]. Chin Med J, 2013, 126(21):4072-4077.
15.	Ruilope LM, Malacco E, Khder Y, et al. Efficacy and tolerability of combination therapy with valsartan plus hydrochlorothiazide compared with amlodipine monotherapy in hypertensive patients with other cardiovascular risk factors:the VAST study[J]. Clin Ther, 2005, 27(5):578-587.
16.	Zhu D, Gao P, Yagi N, et al. Efficacy and tolerability of telmisartan plus amlodipine in Asian patients not adequately controlled on either monotherapy or on low-dose combination therapy[J]. Int J Hypertens, 2014:475480.
17.	Neldam S, Edwards C, Lang M, et al. Long-term tolerability and efficacy of single-pill combinations of telmisartan 40-80 mg plus amlodipine 5 or 10 mg in patients whose blood pressure was not initially controlled by amlodipine 5-10 mg:Open-Label, Long-Term Follow-Ups of the TEAMSTA-5 and TEAMSTA-10 studies[J]. Curr Ther Res Clin Exp, 2012, 73(1/2):65-84.
18.	Lacourcière Y, Neutel JM, Schumacher H. Comparison of fixed-dose combinations of telmisartan/hydrochlorothiazide 40/12.5 mg and 80/12.5 mg and a fixed-dose combination of losartan/hydrochlorothiazide 50/12.5 mg in mild to moderate essential hypertension:pooled analysis of two multicenter, prospective, randomized, open-label, blinded-end point (PROBE) trials[J]. Clin Ther, 2005, 27(11):1795-1805.
19.	Neldam S, Lang M, Jones R, et al. Telmisartan and amlodipine single-pill combinations vs amlodipine monotherapy for superior blood pressure lowering and improved tolerability in patients with uncontrolled hypertension:results of the TEAMSTA-5 study[J]. J Clin Hypertens (Greenwich), 2011, 13(7):459-466.
20.	Zhu DL, Bays H, Gao P, et al. Efficacy and tolerability of initial therapy with single-pill combination telmisartan/hydrochlorothiazide 80/25 mg in patients with grade 2 or 3 hypertension:a multinational, randomized, double-blind, active-controlled trial[J]. Clin Ther, 2012, 34(7):1613-1624.

1. 中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华高血压杂志, 2011, 19(8):701-743.
2. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension:the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2013, 34(28):2159-2219.
3. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults:report from the panel members appointed to the Eighth Joint National Committee (JNC 8)[J]. JAMA, 2014, 311(5):507-520.
4. Sever P. New hypertension guidelines from the National Institute for Health and Clinical Excellence and the British Hypertension Society[J]. J Renin Angiotensin Aldosterone Syst, 2006, 7(2):61-63.
5. 刘国树. β-受体阻滞剂在高血压治疗中的争论再评价[J]. 中国药物应用与监测, 2011, 8(4):195-199.
6. 中华医学会心血管病学分会, 中华心血管病杂志编辑委员. β肾上腺素能受体阻滞剂在心血管疾病应用专家共识[J]. 中华心血管病杂志, 2009, 37(3):195-209.
7. Panjabi S, Lacey M, Bancroft T, et al. Treatment adherence, clinical outcomes, and economics of triple-drug therapy in hypertensive patients[J]. J Am Soc Hypertens, 2013, 7(1):46-60.
8. Baser O, Andrews LM, Wang L, et al. Comparison of real-world adherence, healthcare resource utilization and costs for newly initiated valsartan/amlodipine single-pill combination versus angiotensin receptor blocker/calcium channel blocker free-combination therapy[J]. J Med Econ, 2011, 14(5):576-583.
9. Bangalore S, Kamalakkannan G, Parkar S, et al. Fixed-dose combinations improve medication compliance:a meta-analysis[J]. Am J Med, 2007, 120(8):713-719.
10. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic:the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)[J]. JAMA, 2002, 288(23):2981-2997.
11. Turner RC, Cull CA, Frighi V, et al. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus:progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group[J]. JAMA, 1999, 281(21):2005-2012.
12. Hovater MB, Jaimes EA. Optimizing combination therapy in the management of hypertension:the role of the aliskiren, amlodipine, and hydrochlorothiazide fixed combination[J]. Integr Blood Press Control, 2013, 6:59-67.
13. Lacourcière Y, Poirier L, Hebert D, et al. Antihypertensive efficacy and tolerability of two fixed-dose combinations of valsartan and hydrochlorothiazide compared with valsartan monotherapy in patients with stage 2 or 3 systolic hypertension:an 8-week, randomized, double-blind, parallel-group trial[J]. Clin Ther, 2005, 27(7):1013-1021.
14. Zhu DL, Gao PJ, Liu SW, et al. Efficacy and tolerability of a single-pill combination of telmisartan/hydrochlorothiazide 80/25 mg in Chinese and Korean patients with moderate to severe hypertension:a subgroup analysis of a randomized, double-blind, active-controlled trial[J]. Chin Med J, 2013, 126(21):4072-4077.
15. Ruilope LM, Malacco E, Khder Y, et al. Efficacy and tolerability of combination therapy with valsartan plus hydrochlorothiazide compared with amlodipine monotherapy in hypertensive patients with other cardiovascular risk factors:the VAST study[J]. Clin Ther, 2005, 27(5):578-587.
16. Zhu D, Gao P, Yagi N, et al. Efficacy and tolerability of telmisartan plus amlodipine in Asian patients not adequately controlled on either monotherapy or on low-dose combination therapy[J]. Int J Hypertens, 2014:475480.
17. Neldam S, Edwards C, Lang M, et al. Long-term tolerability and efficacy of single-pill combinations of telmisartan 40-80 mg plus amlodipine 5 or 10 mg in patients whose blood pressure was not initially controlled by amlodipine 5-10 mg:Open-Label, Long-Term Follow-Ups of the TEAMSTA-5 and TEAMSTA-10 studies[J]. Curr Ther Res Clin Exp, 2012, 73(1/2):65-84.
18. Lacourcière Y, Neutel JM, Schumacher H. Comparison of fixed-dose combinations of telmisartan/hydrochlorothiazide 40/12.5 mg and 80/12.5 mg and a fixed-dose combination of losartan/hydrochlorothiazide 50/12.5 mg in mild to moderate essential hypertension:pooled analysis of two multicenter, prospective, randomized, open-label, blinded-end point (PROBE) trials[J]. Clin Ther, 2005, 27(11):1795-1805.
19. Neldam S, Lang M, Jones R, et al. Telmisartan and amlodipine single-pill combinations vs amlodipine monotherapy for superior blood pressure lowering and improved tolerability in patients with uncontrolled hypertension:results of the TEAMSTA-5 study[J]. J Clin Hypertens (Greenwich), 2011, 13(7):459-466.
20. Zhu DL, Bays H, Gao P, et al. Efficacy and tolerability of initial therapy with single-pill combination telmisartan/hydrochlorothiazide 80/25 mg in patients with grade 2 or 3 hypertension:a multinational, randomized, double-blind, active-controlled trial[J]. Clin Ther, 2012, 34(7):1613-1624.

West China Medical Journal

Anti-hypertensive Medication Analysis in A Medical Examination Center

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