Related Experiment Video
Updated: Jun 28, 2025
07:51
Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
Published on: September 26, 2018
7.6K
Differences in Antihypertensive Medication Prescription Profiles Between 2009 and 2021: A Retrospective Cohort Study
Victoria Ivensky1,2, Pitchou Zonga3, Gabriel Dallaire1,4
1Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord-de-l'île-de-Montréal, QC, Canada.
Canadian Journal of Kidney Health and Disease
|April 11, 2024
Summary
Hypertension medication prescribing in Quebec shows suboptimal adherence to guidelines, with limited use of optimal drug combinations. Education initiatives are needed to improve blood pressure control rates in Canada.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Blood pressure (BP) control is crucial for preventing cardiovascular diseases.
- Hypertension control rates in Canada are declining.
- Antihypertensive medication prescription patterns in Quebec require evaluation.
Purpose of the Study:
- To assess changes in antihypertensive medication prescription profiles in Quebec from 2009 to 2021.
- To identify trends in guideline-recommended drug use for hypertension management.
Main Methods:
- Retrospective cohort study using CARTaGENE data linked to administrative health databases.
- Analysis of antihypertensive drug prescription profiles at enrollment (2009-2010) and end of follow-up (March 2021).
- Comparison of prescription practices using chi-square tests, with sensitivity analysis excluding non-hypertension indications.
Main Results:
- Prescription rates for antihypertensive drugs increased from 31.4% to 51.3% between study periods.
- Guideline-recommended monotherapy remained prevalent (77.9% vs 79.5%), while optimal 2- and 3-drug combinations were underutilized.
- Increased use of long-acting thiazide-like diuretics and spironolactone was observed but remained infrequent.
Conclusions:
- Antihypertensive drug prescribing in Quebec demonstrates suboptimal application of hypertension guidelines.
- There is a need for targeted education initiatives to improve prescribing practices.
- Enhancing adherence to guidelines may contribute to improved blood pressure control rates in Canada.
Related Concept Videos
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
61
Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
61
01:25Antihypertensive Drugs: Direct Renin Inhibitors
613
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
613
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
422
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
422
01:28Antihypertensive Drugs: Types of β-Blockers
671
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
671
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
627
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
627
00:59Model-Independent Approaches for Pharmacokinetic Data: Noncompartmental Analysis
62
Noncompartmental analyses offer an alternative method for describing drug pharmacokinetics without relying on a specific compartmental model. In this approach, the drug's pharmacokinetics are assumed to be linear, with the terminal phase log-linear. This assumption allows for simplified analysis and interpretation of the drug's behavior in the body.
One important characteristic of noncompartmental analyses is that drug exposure increases proportionally with increasing doses. This...
One important characteristic of noncompartmental analyses is that drug exposure increases proportionally with increasing doses. This...
62