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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
[Assessment of the utilization of angiotensin receptor blockers in hypertension]
Insights
Angiotensin receptor blockers (ARBs) were inadequately prescribed in 67.3% of cases, often due to misconceptions of superiority over ACE inhibitors. Age and sex did not influence prescription patterns.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Cardiovascular Medicine
Context:
- Hypertension management is crucial for cardiovascular health.
- Angiotensin receptor blockers (ARBs) are widely used antihypertensive agents.
- Evaluating ARB prescription patterns against established criteria is essential for optimizing therapy.
Purpose:
- To evaluate the appropriateness of Angiotensin Receptor Blocker (ARB) utilization in a specific healthcare area against Madrid Community criteria.
- To analyze the indications for ARB prescriptions.
- To identify factors influencing ARB prescription practices.
Summary:
- A descriptive, cross-sectional study analyzed 153 hypertensive patients prescribed ARBs.
- Results showed a 67.3% inadequate prescription rate, with common issues including ARBs as first-line renin-angiotensin-aldosterone system inhibitors and poor blood pressure control with ACE inhibitors.
- No significant associations were found between age/sex and prescription appropriateness or indications.
Impact:
- The study highlights suboptimal ARB prescribing, with only 32.7% meeting criteria.
- Findings suggest a need to address misconceptions regarding ARB superiority over ACE inhibitors.
- This evaluation can inform targeted interventions to improve ARB use in hypertension management.
Objective:
To assess the degree in which the utilization of angiotensin receptor blockers (ARBs) in our Healthcare Area fits the criteria proposed by the Autonomous Community of Madrid (CAM) before setting «Plan de Actuación de ARA-II» («Action Plan ARA-II»). To study the indications for which are prescribed and to identify those factors that can show influence in prescription.
Methods:
Drug utilization study of the type indication-prescription, descriptive and transversal, for which ARBs-treated and hypertensive patients admitted to a University General Hospital for a study period of 3 months were selected. Based on the clinical situations summarized in the CAM Document «Criterios para establecer el lugar en la terapéutica de los antagonistas de los receptores de la angiotensina II» («Criteria for the place of angiotensin receptor blockers in the therapeutic»), a percentage of patients with «appropriate prescription» and «inadequate prescription« of ARBs was calculated and analyzed in order to determine if the age and the sex were related to the type of prescription or the main indications for which they had been prescribed.
Results:
Out of the 153 patients included in the study, 67.3% had a «inadequate prescription«, 47.6% of them due to an ARBs prescription as the first drug inhibitor of the reninangiotensin- aldosterone system and 34.0% owing to a poor control of blood pressure with angiotensin-converting enzyme inhibitors (ACEi). There were no statistically significant differences found either by age or sex in the type of prescription or in the main indications for which they were prescribed.
Conclusions:
The adequacy of the criteria for the utilisation of ARBs Document occurred in 32.7% of cases. In addition, factors such as age and sex did not seem to affect the type of prescription. Misconceptions of superiority of ARBs versus ACEi were evidenced as well.
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