Frequency of Antihypertensive Drug Classes and Single-Pill Combinations in Obese Patients: An 8-Year Retrospective Study

IF 2.5 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Beata Moczulska, Karolina Osowiecka, Leszek Gromadziński, Marta Majewska
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Abstract

Obesity is a major contributor to the development and progression of hypertension, and its coexistence significantly increases cardiovascular risk. Although numerous guidelines exist for the management of arterial hypertension, none are dedicated specifically to obese patients, despite their increasing prevalence. Since 2018, both European and Polish guidelines have recommended the use of single-pill combinations (SPCs) at every stage of treatment. This retrospective study aimed to evaluate antihypertensive treatment patterns over the past eight years among obese patients. This analysis was restricted to obese patients with hypertension to explore prescribing patterns in a subgroup with unique pathophysiological features and high cardiovascular risk, for which specific therapeutic recommendations remain limited. The study cohort was limited to obese patients hospitalized for preoperative assessment prior to planned bariatric surgery. We analyzed medical records of 233 obese hypertensive patients divided into two cohorts: those diagnosed before 2020 and those diagnosed in 2020 or later. We observed a significant increase in the use of three or more antihypertensive drugs and a rise in the prescription of beta-blockers and angiotensin receptor blockers after 2020. Despite these changes, the use of SPCs remained low: two-drug SPCs were used in 35.6% of patients, and three-drug SPCs in only 11.2%, with no significant increase in their use over time. Additionally, SGLT2 inhibitors were introduced into therapy after 2020. Our findings highlight the discrepancy between clinical guidelines and real-world prescribing habits. Improved adherence to treatment recommendations may enhance therapeutic outcomes and medication adherence in this high-risk group.

Abstract Image

肥胖患者抗高血压药物种类和单药组合的频率:一项8年回顾性研究
肥胖是高血压发生发展的主要因素,其共存显著增加心血管风险。虽然有许多动脉高血压的治疗指南,但没有一个是专门针对肥胖患者的,尽管肥胖患者的患病率越来越高。自2018年以来,欧洲和波兰的指南都建议在治疗的每个阶段使用单丸组合(spc)。本回顾性研究旨在评估肥胖患者过去8年的降压治疗模式。该分析仅限于肥胖高血压患者,以探索具有独特病理生理特征和心血管风险高的亚组的处方模式,具体的治疗建议仍然有限。研究队列仅限于计划减肥手术前住院进行术前评估的肥胖患者。我们分析了233名肥胖高血压患者的医疗记录,这些患者被分为两组:在2020年之前诊断的患者和在2020年或之后诊断的患者。我们观察到,2020年后,使用三种或三种以上降压药的人数显著增加,β受体阻滞剂和血管紧张素受体阻滞剂的处方也有所增加。尽管有这些变化,SPCs的使用仍然很低:使用两种药物SPCs的患者占35.6%,使用三种药物SPCs的患者仅占11.2%,并且随着时间的推移,SPCs的使用没有显著增加。此外,SGLT2抑制剂在2020年后被引入治疗。我们的发现强调了临床指南和现实世界处方习惯之间的差异。提高对治疗建议的依从性可以提高这一高危人群的治疗效果和药物依从性。
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来源期刊
Journal of Clinical Hypertension
Journal of Clinical Hypertension PERIPHERAL VASCULAR DISEASE-
CiteScore
5.80
自引率
7.10%
发文量
191
审稿时长
4-8 weeks
期刊介绍: The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.
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