Rational Pharmacotherapy in Cardiology

Advanced search


Full Text:


Aim. To compare different strategies of start antihypertensive therapy in out-patients.

Material and methods. 120 out-patients with arterial hypertension (HT) 1-2 stages were included in the study and randomized in 3 groups. Patients of group «A» received start treatment in compliance with age, clinical features and mechanisms of hypertension. Patients of group «B» received step-by-step start antihypertensive therapy based on doses titration and addition of the second (third) drug if necessary. Patients of group «C» received fixed drug combination with addition of other antihypertensive medicines if necessary. Decrease of BP level and number of visits were used as criteria of therapy efficacy. Pharmacoeconomic analysis of antihypertensive therapy was done in all groups.

Results. Strategy of HT start therapy in group «C» had advantages in speed of blood pressure normalization, number of necessary visits and in pharmacoeconomic efficacy in comparison with the strategies in group «A» and «B».

Conclusion. HT start therapy with implementation of fixed low dose combination leads to the best result in comparison with other strategy based on step-by-step drug replacement (as well as their combining) or monotherapy dose titration.

About the Authors

O. A. Plejko
Kaliningrad Regional Clinical Hospital
Russian Federation

A. O. Konradi
V.A.Almazov Federal Heart, Blood and Endocrinology Centre of Rosmedtechnology, Akkuratova ul. 2, Saint-Petersburg, 197341 Russia
Russian Federation


1. Еlliott W.J. The costs of treating hypertension: what are the long-term realities of cost containment and pharmacoeconomics? Postgrad Med 1996; 99(4):241-8, 251-2.

2. Ипатов А.И., Арабидзе Г.Г., Теблоев К.И. и др. Клиническая оценка эффективности и безопасности терапии нолипрелом больных с АГ. Кардиология 2002;(9):49-52.

3. 2007 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 Hypertens 2007; 25(6):1105-87.

4. Гиляревский С.Р., Орлов В.А. Использование анализа эффективности лечения для принятия клинического решения в кардиологии. Кардиология 1997;(9):70–80.

5. Flack J.M., Novikov S.V., Ferrario C.M. Benefits of adherence to anti-hypertensive drug therapy. Eur Heart J 1996; 17 Suppl A:16-20.

6. Drummond M.F. Resource allocation decision in health care: a role for quality of life assessments? J Chron Dis 1987;40(6):605-19.

7. O’Brien B. Principles of economic evaluation for health care programs. J Rheumatol 1995;22(7):1399–402

8. Jonsson B. Measurement of health outcome and associated costs in cardiovascular disease. Europ Heart J 1996; 17 Suppl A:2-7. 9. Bowling A. Research methods in health. Investigating health and health services. – Buckinham-Philadelphia: Open University Press; 1997. P. 79–98.

9. Doubilet P., Weinstein M.C., McNeil B.J. Use and misuse of the term "Cost effective" in medicine. N Engl J Med 23;314(4):253-6.

10. Kuppermann M., Luce B.R., McGovern B. et al. An analysis of the cost effectiveness of the implantable defibrillator. Circulation 1990;81:91– 100.

11. Плейко О.А., Конради А.О. Эффективность различных алгоритмов подбора антигипертензивной терапии. Рационал фармакотер кардиол 2007;(1):21-7.

12. Mourad J.J., Waeber B., Zannad F. Comparison of different therapeutic strategies in hypertension: a low-dose combination of perindopril/indapamide versus a sequential monotherapy or a stepped-care approach. J Hypertens 2004;22(12):2379-86.

13. Stergiou G.S., Karotsis A.K., Symeonidis A., Vassilopoulou V.A. Aggressive blood pressure control in general practice (ABC-GP) study: can the new targets be reached? J Hum Hypertens 2003 ;17(11):767-73.

For citation:

Plejko O.A., Konradi A.O. COMPARISON OF DIFFERENT STRATEGIES OF ANTIHYPERTENSIVE THERAPY IN OUT-PATIENT CLINIC. Rational Pharmacotherapy in Cardiology. 2008;4(4):40-46. (In Russ.)

Views: 321

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)