Kosuyolu Heart J 2013;16(1)
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Kosuyolu Heart J 2013;16(1):7-12 - doi: 10.5578/kkd.4472
Frequent Change of Intra-group Drug Effect on the Blood Pressure Control and Adaptation of Therapy in Hypertensive Patients

Frequent Change of Intra-group Drug Effect on the Blood Pressure Control and
Adaptation of Therapy in Hypertensive Patients

Müslüm Şahin1, Serdar Demir1, Süleyman Aktürk2, Ali Fedakar3, Gökhan Alıcı1, Birol Özkan1,
Mehmet Vefik Yazıcıoğlu1, Cantürk Çakalağaoğlu3, Mustafa Yıldız1, Ali Metin Esen1,
Mehmet Muhsin Türkmen1


1 Department of Cardiology, Kosuyolu Heart Center, Kartal, Istanbul, Turkey

2 Department of Cardiology, Private Gebze Yuzyil Hospital, Kocaeli, Turkey

3 Department of Cardiovascular Surgery, Kosuyolu Heart Center, Kartal, Istanbul, Turkey

ABSTRACT

Introduction: In this study, we investigated the effects of frequent and unnecessary change in medication to control of blood pressure. Also we investigated the role of the regular use of drugs in the treatment of hypertension.

Patients and Methods: Nine hundred hypertensive patients (509 males and 391 females; mean age 62.4 ± 12.1 years) were evaluated retrospectively. Only the patients taking anti-hypertensives for at least six months were included. Patients' records were examined in terms of anti-hypertensive treatment. Intra-group exchange and use of regularly in anti-hypertensive drugs were investigated. Effects of the change in blood pressure and patient compliance were investigated.

Results: When intra-group drug change was examined, rates of drug changes were as follows; angiotensin receptor blocker group, 62.3%; angiotensin converting enzyme group, 55.1%; beta-blockers group, 39.9%; calcium channel blocker group, 20.9%. While the ratio of non-compliance was 28.7% in the patient group with drug change, it was only 9.3% in the group without change in treatment. Average blood pressure difference was found 6.1 ± 7.6 mmHg and 7.6 ± 7.5 mmHg respectively (p < 0.001). The average number of drug usage with and without change of anti-hypertensive drug were 2.5 ± 0.87 and 2.2 ± 0.89 (p < 0.001) respectively.

Conclusion: In patients under angiotensin converting enzyme inhibitors and angiotensin receptor blocker treatments, intra-group change of medication is common. Frequent intra-group change of anti-hypertensive drugs has negative effects on blood pressure control.

Key Words: Hypertension; drug switching; patient compliance.

Received: 06.10.2012 Accepted: 13.11.2012

Correspondence

Dr. Müslüm Şahin

Kartal Koşuyolu Yüksek İhtisas Eğitim ve

Araştırma Hastanesi, Kardiyoloji Kliniği,

Cevizli Kavşağı No: 2 34846

Cevizli, İstanbul-Türkiye

e-posta: sahinm78@yahoo.com

Frequent Change of Intra-group Drug Effect on the Blood Pressure Control and Adaptation of Therapy in Hypertensive Patients

Hipertansif Hastalarda Grup İçi Sık İlaç Değişiminin Kan Basıncı Kontrolüne ve
Tedavi Uyumuna Etkisi

Frequent Change of Intra-group Drug Effect on the Blood Pressure Control and
Adaptation of Therapy in Hypertensive Patients

Müslüm Şahin1, Serdar Demir1, Süleyman Aktürk2, Ali Fedakar3, Gökhan Alıcı1, Birol Özkan1,
Mehmet Vefik Yazıcıoğlu1, Cantürk Çakalağaoğlu3, Mustafa Yıldız1, Ali Metin Esen1,
Mehmet Muhsin Türkmen1


1 Department of Cardiology, Kosuyolu Heart Center, Kartal, Istanbul, Turkey

1 Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye

2 Department of Cardiology, Private Gebze Yuzyil Hospital, Kocaeli, Turkey

2 Özel Gebze Yüzyıl Hastanesi, Kardiyoloji Kliniği, Kocaeli, Türkiye

3 Department of Cardiovascular Surgery, Kosuyolu Heart Center, Kartal, Istanbul, Turkey

3 Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İstanbul, Türkiye

ÖZET

Giriş: Bu çalışmada sık ve gereksiz ilaç değişiminin kan basıncı kontrolü üzerindeki etkisini araştırdık. Ayrıca, hipertansiyon tedavisinde düzenli ilaç kullanımının rolü çalışıldı.

Hastalar ve Yöntem: Dokuz yüz hipertansif hasta (509 erkek ve 391 kadın; yaş ortalaması 62.4 ± 12.1 yıl) geriye dönük olarak değerlendirildi. En az altı aydır antihipertansif ilaç alan hastalar çalışmaya dahil edildi. Hasta kayıtları antihipertansif tedavi yönünden incelendi. Grup içi değişim ve antihipertansif ilaçların düzenli kullanımı araştırıldı. Değişimin kan basıncı ve hasta uyumuna etkisi araştırıldı.

Bulgular: Grup içi ilaç değişim oranları; anjiyotensin reseptör bloker grubunda,%62.3; anjiyotensin dönüştürücü enzim grubunda,%55.1; beta-bloker grubunda,%39.9; kalsiyum kanal bloker grubunda,%20.9 olarak bulundu. Düzensiz ilaç kullanım oranı ilaç değişikliği olan hasta grubunda %28.7 iken, ilaç değişikliği olmayan hasta grubunda sadece %9.3 idi. Ortalama kan basıncı farkı sırasıyla 6.1 ± 7.6 mmHg ve 7.6 ± 7.5 mmHg idi (p < 0.001). Antihipertansif ilaç değişimi olan ve olmayan gruplarda kullanılan ortalama ilaç sayısı sırası ile 2.5 ± 0.87 ve 2.2 ± 0.89 idi (p < 0.001).

Sonuç: Anjiyotensin dönüştürücü enzim inhibitörleri ve anjiyotensin reseptör bloker tedavisi altındaki hastalarda grup içi ilaç değişimi yaygındır. Antihipertansif ilaçların grup içi sık değişimi kan basıncı kontrolünü olumsuz etkiler.

Anahtar Kelimeler: Hipertansiyon, sık ilaç değişimi, hasta uyumu.

Geliş Tarihi: 06.10.2012 Kabul Tarihi: 13.11.2012

ABSTRACT

Introduction: In this study, we investigated the effects of frequent and unnecessary change in medication to control of blood pressure. Also we investigated the role of the regular use of drugs in the treatment of hypertension.

Patients and Methods: Nine hundred hypertensive patients (509 males and 391 females; mean age 62.4 ± 12.1 years) were evaluated retrospectively. Only the patients taking anti-hypertensives for at least six months were included. Patients' records were examined in terms of anti-hypertensive treatment. Intra-group exchange and use of regularly in anti-hypertensive drugs were investigated. Effects of the change in blood pressure and patient compliance were investigated.

Results: When intra-group drug change was examined, rates of drug changes were as follows; angiotensin receptor blocker group, 62.3%; angiotensin converting enzyme group, 55.1%; beta-blockers group, 39.9%; calcium channel blocker group, 20.9%. While the ratio of non-compliance was 28.7% in the patient group with drug change, it was only 9.3% in the group without change in treatment. Average blood pressure difference was found 6.1 ± 7.6 mmHg and 7.6 ± 7.5 mmHg respectively (p < 0.001). The average number of drug usage with and without change of anti-hypertensive drug were 2.5 ± 0.87 and 2.2 ± 0.89 (p < 0.001) respectively.

Conclusion: In patients under angiotensin converting enzyme inhibitors and angiotensin receptor blocker treatments, intra-group change of medication is common. Frequent intra-group change of anti-hypertensive drugs has negative effects on blood pressure control.

Key Words: Hypertension; drug switching; patient compliance.

Received: 06.10.2012 Accepted: 13.11.2012

Yazışma Adresi/Correspondence

Dr. Müslüm Şahin

Kartal Koşuyolu Yüksek İhtisas Eğitim ve

Araştırma Hastanesi, Kardiyoloji Kliniği,

Cevizli Kavşağı No: 2 34846

Cevizli, İstanbul-Türkiye

e-posta: sahinm78@yahoo.com

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