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Combination antihypertensive therapy in clinical practice. The analysis of 1254 consecutive patients with

O Petrák1, T Zelinka1, B Štrauch1

  • 13rd Department of Medicine-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic.

Journal of Human Hypertension
|April 3, 2015
PubMed

Insights

Many patients with uncontrolled hypertension receive inappropriate combination therapy. Common issues include underdosed diuretics and incorrect drug combinations, potentially worsening hypertension management.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Uncontrolled hypertension remains a significant global health challenge.
  • Effective management often requires combination antihypertensive therapy.
  • Optimizing combination therapy is crucial for achieving blood pressure control.

Purpose of the Study:

  • To analyze the clinical application of various combination therapies in patients with uncontrolled hypertension.
  • To identify patterns of inappropriate antihypertensive drug combinations.
  • To assess the prescribing practices of different antihypertensive drug classes.

Main Methods:

  • Retrospective analysis of 1254 consecutive patients with uncontrolled hypertension.
  • Inclusion criteria: patients receiving at least triple-combination antihypertensive therapy.
  • Data collection on prescribed antihypertensive classes and dosages.

Main Results:

  • Renin-angiotensin blockers, calcium channel blockers, and diuretics were most prescribed.
  • Thiazide/thiazide-like diuretics were underdosed in over two-thirds of patients.
  • Inappropriate combination therapy identified in 40.4% of patients, including dual renin-angiotensin system blockade (25.2%) and drugs with similar mechanisms (28.1%).

Conclusions:

  • The use of controversial or incorrect drug combinations in uncontrolled hypertension is prevalent.
  • Diuretics are often underdosed, and spironolactone is underutilized.
  • Improper combination therapy likely contributes to persistent uncontrolled hypertension.

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