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COMBINED ANTIHYPERTENSIVE THERAPY IN REAL CLINICAL PRACTICE. FOCUS ON FIXED COMBINATIONS OF ANTIHYPERTENSIVE DRUGS (According to the Data of Outpatient Registries RECVASA and PROFILE)

https://doi.org/10.20996/1819-6446-2017-13-3-323-329

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Abstract

On Behalf of the Working Groups of the Registries PROFILE and REСVASA. 

Working Group of the PROFILE Registry: Akimova A.V., Voronina V.P., Dmitrieva N.A., Zakharova A.V., Zakharova N.A., Zagrebelnyy A.V., Kutishenko N.P., Lerman O.V., Lukina Yu.V., Tolpygina S.N., Martsevich S.Y.

Working Group of the RECVASA Registry: Vorobyev A.N., Zagrebelnyy A.V., Kozminsky A.N., Lukina Yu.V., Loukianov M.M., Moseichuk K.A., Nikulina N.N., Pereverzeva K.G., Pravkina E.A., Boytsov S.A., Martsevich S.Yu., Yakushin S.S.

Aim. To assess the frequency of prescription of different combinations of the main groups of antihypertensive drugs (AHD) and their fixed combinations to patients with arterial hypertension by physicians according to two outpatient registries.

Material and methods. Hypertension was diagnosed in 3648 (98.9%) patients of the RECVASA registry and in 1230 patients of the PROFILE registry (80.3%). Data on doctor’s prescriptions reflected in the outpatient charts of patients of the both registries were analyzed. The following information of the prescribed antihypertensive therapy was studied in details: AHD, including fixed and free combinations, original and generic AHD. Data on the achievement/non-achievement of target blood pressure (BP) level in patients with hypertension were also analyzed.

Results. Women were predominated among hypertensive patients of the RECVASA registry, (71.9%). The ratio of men and women was close to 1:1 in the PROFILE registry. Patients of the registry RECVASA were older: the average age was 66.2±12.8 years compared to 63.7±11.4 years in patients of the PROFILE registry, respectively. The majority of patients in the RECVASA registry (61.4%) had hypertension of the 3rd degree, patients of the PROFILE registry revealed mostly hypertension of the 2 degree (53.3%). Fixed combinations were prescribed to 14% of patients in the registry of RECVASA and to 16% of patients in the PROFILE registry. Doctors of the PROFILE registry often prescribed original AHD; 75% of patients from RECVASA registry received generics. The most popular combinations in both registries were combinations of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers with thiazide/thiazide-like diuretics. The target level of BP was more often achieved in the patients of the PROFILE registry: 37.6% vs 26.1% in the RECVASA registry.

Conclusion. The results of the analysis of the presented registries demonstrate the low frequency of prescribing fixed combinations in real clinical practice, the inertness of physicians in achieving the target BP levels and the low efficiency of antihypertensive therapy.


About the Authors

S. Yu. Martsevich
State Research Centre for Preventive Medicine
Russian Federation

Sergey Yu. Martsevich – MD, PhD, Professor, Head of Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990



Yu. V. Lukina
State Research Centre for Preventive Medicine
Russian Federation

Yulia V. Lukina – MD, PhD, Leading Researcher, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990



A. V. Zagrebelnyy
State Research Centre for Preventive Medicine
Russian Federation

Alexander V. Zagrebelnyy – MD, PhD, Senior Researcher, Department of Preventive Pharmacotherapy 

Petroverigsky per. 10, Moscow, 101990



M. M. Loukianov
State Research Centre for Preventive Medicine
Russian Federation

Michail M. Loukianov – MD, PhD, Leading Researcher, Department of Clinical Cardiology and Molecular Genetics 

Petroverigsky per. 10, Moscow, 101990



A. N. Vorobyev
I.P. Pavlov Ryazan State Medical University
Russian Federation

Alexander N. Vorobyev – MD, PhD, Assistant, Chair of Hospital Therapy 

Vysokovoltnaya ul. 9, Ryazan, 390026



E. A. Pravkina
I.P. Pavlov Ryazan State Medical University
Russian Federation

Ekaterina A. Pravkina – MD, PhD, Assistant, Chair of Hospital Therapy 

Vysokovoltnaya ul. 9, Ryazan, 390026



N. O. Myasnikova
Pirogov Russian National Research Medical University
Russian Federation

Sixth-Year Student 

Ostrovitianova ul. 1, Moscow, 117997



References

1. Neuner-Jehle S. Polypharmacy, the new epidemic. Rev Med Suisse. 2016;12(518):942-7

2. Gupta A.K., Arshad S., Poulter N.R. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension. 2010; 55(2):399-407

3. 2013 ESH/ESC 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). Eur Heart J. (2013) 34, 2159-2219

4. Lukina Yu.V., Dmitrieva N.A., Zakharova A.V. et al. Adverse event of drug therapy (the first results of the study according to the PROFILE outpatient registry). Ration Pharmacother Cardiol. 2016;12(3):306-13. (In Russ.) [Лукина Ю.В., Дмитриева Н.А., Захарова А.В. и др. Нежелательные явления лекарственной терапии (первые результаты исследования по данным амбулаторного регистра ПРОФИЛЬ). Рациональная Фармакотерапия в Кардиологии. 2016;12(3):326-33]

5. Loukianov M.M., Boytsov S.A., Yakushin S.S., et al. Сoncomitant cardiovascular diseases and antihypertensive treatment in outpatient practice (by the RECVASA registry data). Ration Pharmacother Cardiol. 2016;12(1):4-15. (In Russ.) [Лукьянов М.М., Бойцов С.А., Якушин С.С., и др. Сочетанные сердечно-сосудистые заболевания и антигипертензивное лечение у больных артериальной гипертонией в амбулаторно-поликлинической практике (по данным Регистра РЕКВАЗА). Рациональная Фармакотерапия в Кардиологии. 2016;12(1):4-15]

6. Martsevich S.Yu., Gaysenok O.V., Tripkosh S.G., et al. Мedical supervision in specialized center and the quality of lipid-lowering therapy in patients with cardiovascular diseases (according to the PROFIL registry). Ration Pharmacother Cardiol. 2013;9(2):133-7. (In Russ.) [Марцевич С.Ю., Гайсёнок О.В., Трипкош С.Г. и др. Наблюдение в специализированном медицинском центре и качество гиполипидемической терапии у пациентов с сердечно-сосудистыми заболеваниями (по данным регистра ПРОФИЛЬ). Рациональная Фармакотерапия в Кардиологии. 2013;9(2):133-7]

7. Gupta A.K., Arshad S., Poulter N.R. Compliance, Safety, and Effectiveness of Fixed-Dose Combinations of Antihypertensive Agents A Meta-Analysis. Hypertension. 2010;55:399-407

8. Leonova M.V., Belousov D.Yu., analytical research group PIFAGOR. The first Russian pharmacoepidemiological study of arterial hypertension. Kachestvennaya Klinicheskaya Praktika. 2002; 3: 47-53. (InRuss.) [Леонова М.В., Белоусов Д.Ю., аналитическая группа исследования ПИФАГОР. Первое российское фармакоэпидемиологическое исследование артериальной гипертонии. Качественная Клиническая Практика. 2002;3:47-53]

9. Shalnova S.A., Deev A.D., Vikhireva O.V. on behalf of the participants of the survey. Arterial hypertension with the eyes of outpatients. The first results of the GARANT study. Kardiovaskulyarnaya Terapiya i Profilaktika. 2007;6(5):30-3. (InRuss.) [Шальнова С.А., Деев А.Д., Вихирева О.В. от имени участников исследования. Артериальная гипертония глазами амбулаторных пациентов. Первые результаты исследования ГАРАНТ. Кардиоваскулярная Терапия и Профилактика. 2007;6(5):30-3]

10. Oganov R.G., Pogosova G.V., Koltunov I.E., et al. Regular treatment and prophylaxis is the key to improving the situation with cardiovascular diseases in Russia: the results of a Russian multicentre study. Part III. Kardiologiia. 2008;4:46-53. (In Russ.) [Оганов Р.Г., Погосова Г.В., Колтунов И.Е. и др. Регулярное лечение и профилактика – ключ к улучшению ситуации с сердечно-сосудистыми заболеваниями в России: результаты российского многоцентрового исследования. Часть III. Кардиология. 2008;4:46-53]

11. Kontsevaya A.V., Romanenko T.S., Vygodin V.A., Fitilev S.B. Pharmacoepidemiology and the effectiveness of antihypertensive therapy in the real practice of a specialized cardiological institution. Rational Pharmacotherapy in Cardiology. 2015;11(1):8-17. (In Russ.) [Концевая А.В., Романенко Т.С., Выгодин В.А., Фитилев С.Б. Фармакоэпидемиология и эффективность антигипертензивной терапии в реальной практике специализированного кардиологического учреждения. Рациональная Фармакотерапия в Кардиологии. 2015;11(1):8-17]

12. Leonova M.L., Shteinberg L.L., Belousov Yu.B., et al. Pharmacoepidemiology of arterial hypertension in Russia: analysis of adherence of doctors (according to the results of the PIFAGOR IV study). Sistemnye Gipertenzii. 2015; 12 (1): 19-25 (In Russ.) [Леонова М.Л., Штейнберг Л.Л., Белоусов Ю.Б. и др. Фармакоэпидемиология артериальной гипертонии в России: анализ приверженности врачей (по результатам исследования ПИФАГОР IV). Системные Гипертензии. 2015;12(1):19-25]

13. Martsevich S.Yu., Lukina Yu.V., Kutishenko N.P., et al. Study of adherence to therapy in patients with metabolic syndrome with the example of a new combination antihypertensive drug ramipril and amlodipine (based on the results of the observational study "GRANAT-1." Kardiovaskulyarnaya Terapiya i Profilaktika. 2017;16(1):67-73. (In Russ.) [Марцевич С.Ю., Лукина Ю.В., Кутишенко Н.П. и др. Изучение приверженности к терапии у пациентов с метаболическим синдромом на примере нового комбинированного антигипертензивного препарата рамиприла и амлодипина (по результатам наблюдательного исследования «ГРАНАТ-1». Кардиоваскулярная Терапия и Профилактика. 2017;16(1):67-73]

14. Martsevich S.Yu., Lukina Yu.V., Kutishenko N.P., et al. Study of tolerability parameters and adherence to therapy in patients with chronic obstructive pulmonary disease and arterial hypertension in the context of treatment with a fixed combination of ramipril and amlodipine (based on the results of the observational study "GRANAT-2"). Rational Pharmacotherapy in Cardiology. 2017;132(2):229-37. (In Russ.) [Марцевич С.Ю., Лукина Ю.В., Кутишенко Н.П. и др. Изучение параметров переносимости и приверженности к терапии у пациентов с хронической обструктивной болезнью легких и артериальной гипертонией на фоне лечения фиксированной комбинацией рамиприла и амлодипина (по результатам наблюдательного исследования «ГРАНАТ-2»). Рациональная Фармакотерапия в Кардиологии. 2017;132(2):229-37]


For citation:


Martsevich S.Y., Lukina Y.V., Zagrebelnyy A.V., Loukianov M.M., Vorobyev A.N., Pravkina E.A., Myasnikova N.O. COMBINED ANTIHYPERTENSIVE THERAPY IN REAL CLINICAL PRACTICE. FOCUS ON FIXED COMBINATIONS OF ANTIHYPERTENSIVE DRUGS (According to the Data of Outpatient Registries RECVASA and PROFILE). Rational Pharmacotherapy in Cardiology. 2017;13(3):323-329. (In Russ.) https://doi.org/10.20996/1819-6446-2017-13-3-323-329

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