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Published on: September 26, 2018
[Relationship between cardiovascular risk profile and anti-hypertensive drug use. GEDEC (Spanish group of
A de la Sierra1, L M Ruilope, A Coca
1Unidad de Hipertensión, Hospital Clínic, Barcelona. iserte@medicina.ub.es
Insights
Cardiovascular risk and co-morbidities have limited impact on antihypertensive drug selection. Treatment individualization based on specific patient conditions is crucial for effective hypertension management.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Context:
- Current hypertension guidelines prioritize absolute cardiovascular risk for treatment selection.
- Concomitant conditions necessitate specific antihypertensive drug classes.
- Understanding drug class utilization in relation to risk and comorbidities is essential.
Purpose:
- To analyze the relationship between cardiovascular risk profile and co-morbid conditions on antihypertensive drug class use.
- To evaluate how patient characteristics influence the choice of hypertension medications.
Summary:
- Observational study of 2,850 essential hypertensive patients.
- Diabetes, cerebrovascular, and coronary diseases influenced the use of calcium channel blockers (CCB) and ACE inhibitors.
- Hypercholesterolemia and smoking did not affect drug class selection; diuretics and angiotensin II receptor antagonists were used more in cardiac failure.
Impact:
- Cardiovascular risk profile shows limited influence on antihypertensive drug class choice, especially with hypercholesterolemia or cardiac failure.
- Highlights the need for individualized hypertension treatment plans considering specific patient comorbidities.
- Informs clinical practice regarding tailored antihypertensive therapy based on patient profiles.
Background:
Hypertension guidelines emphasize the selection of antihypertensive treatment on the basis of absolute cardiovascular risk. Moreover, compelling and possible indications for each antihypertensive drug class are recommended for patients with other concomitant conditions. The aim of the present study was to analyze the relationship between the cardiovascular risk profile and co-morbid conditions on antihypertensive drug class use.
Methods:
This is an observational, multicenter, cross-sectional study performed in 2,850 essential hypertensive patients. Antihypertensive drug treatment has been evaluated on the basis of the presence of other cardiovascular risk factors, target organ damage or cardiovascular diseases, as well as the absolute cardiovascular risk profile.
Results:
Patients with diabetes were treated more frequently with calcium channel blockers (CCB) and ACE inhibitors. However, the presence of hypercholesterolemia or smoking habit did not influence the use of antihypertensive drug classes. The presence of cerebrovascular disease increased the use of CCB and ACE inhibitors, whereas coronary disease increased the use of CCB and betablockers. The use of diuretics and angiotensin II receptor antagonists was increased in patients with cardiac failure, whereas neither betablockers nor ACE inhibitors were affected by this concomitant disease. Patients with the highest cardiovascular risk received more antihypertensive treatment than those with lower risk, but this was not accompanied by switching from old classes to new ones.
Conclusion:
Cardiovascular risk profile seems to have little influence on the use of antihypertensive drug classes, particularly the presence of hypercholesterolemia or cardiac failure. It seems adequate to emphasize the necessity of an individualization of antihypertensive treatment, based on the presence of concomitant conditions that influence the absolute cardiovascular risk.
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