Publication: Kardiyovasküler komorbiditesi bulunan ve bulunmayan esansiyel hipertansiyon hastalarında ilaç kullanımının araştırılması
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Date
2020
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Abstract
Amaç: Hipertansiyon, komorbiditesi sık bir hastalık olup bu durum tedaviyidüzenlenmede belirleyicidir. Bu çalışmada hipertansif hastalarda başkakardiyovasküler sorunların olup olmama durumuna göre ilaç kullanımınınincelenmesi amaçlandıGereç ve Yöntem: Bu retrospektif çalışmaya Türk Kalp Vakfı Tıp Merkezi’ninOcak 2016-Haziran 2018 arasındaki hasta verileri dahil edildi (n=11.085).Hastalara ait kayıtlı tanılar içerisinde (n=26.699) en sık karşılaşılan üç tanı olanhipertansiyon (HT), iskemik kalp hastalığı (İKH) ve dislipidemi (DL)bulunanların tedavilerindeki ilaçlar, tıbbi ve demografik özelliklerideğerlendirildi. Hipertansiyon verileri ile buna eşlik eden İKH ve DL verilerikarşılaştırıldı.Bulgular: Çalışma periyodunda oluşturulan protokollerin %22,2’sini (n=5929)HT oluşturmaktaydı. Toplam 3601 HT tanılı hastanın %43,7’sini (n=1572) tektanılı olanlar, %36,7’sini ise (n=1321) eşlik eden iki komorbiditenin en az biriniiçeren hastalar oluşturuyordu. İncelenen tüm tanı gruplarında en sık karşılaşılanilaç asetilsalisilik asit idi. En sık karşılaşılan antihipertansif ana ilaç grubu reninanjiyotensin sistemi (RAS) blokerleri, etkin maddeler ise metoprolol veamlodipin idi. Bunu tek başına HT ve HT’ye DL’nin eşlik ettiği grupta“valsartan+hidroklorotiyazid”, İKH’nin eşlik ettiği gruplarda ramipril izliyordu.Beta-bloker kullanımı ≥65 yaş hastalarda genç hastalara kıyasla daha düşüktü(sırasıyla %13,8 ve %16,1, p<0,05).Sonuç: Bu çalışmada en çok tercih edilen antihipertansif grubun, anjiyotensinreseptör blokerlerinin baskınlığında, RAS üzerinden etkililer, en çok tercih edilenilacın ise metoprolol olduğu göze çarpmaktadır. Son yıllardaki kılavuzlarda betabloker kullanımının nispeten geri plana düşmüş olmasına rağmen, bu çalışmadahipertansif hastalarda yaygın olarak kullanıldığı görülmektedir. Hipertansiyonaeşlik eden iki durumda da en sık kullanılan ilaçların genel olarak değişkenlikgöstermediği anlaşılmaktadır.
Objective: Comorbidities are common in hypertension (HT) and determine the_x000D_ management of antihypertensive therapy. We aimed to investigate drug_x000D_ utilization in hypertensive patients in associaition with the presence of other_x000D_ cardiovascular problems._x000D_ Materials and Methods: This retrospective study included data of patients_x000D_ applied to the Turkish Heart Foundation Medical Center between January 2016-_x000D_ June 2018 (n=11,085). Among all medical records (n=26,699), medications,_x000D_ medical and demographic characteristics were evaluated in patients with most_x000D_ common diagnosis: HT, ischemic heart disease (IHD), and dyslipidemia (DL)._x000D_ Data for HT and accompanying IHD and DL were compared._x000D_ Results: 22.2% (n=5,929) of the visits had diagnosis of HT. Of the total 3,601 HT_x000D_ patients, 43.7% (n=1,572) had single diagnosis and 36.7% (n=1,321) had at least_x000D_ one of the two comorbidities. Acetylsalicylic acid was the most common drug in_x000D_ all groups. The most common antihypertensive group was renin-angiotensin_x000D_ system (RAS) blockers and the active molecules were metoprolol and_x000D_ amlodipine. This was followed by “valsartan+hydrochlorothiazide” in HT alone_x000D_ or HT+DL groups and by ramipril in the groups where IHD accompanied. The_x000D_ use of beta-blockers was lower in patients ≥65 years compared to younger_x000D_ patients (13.8% and 16.1%, respectively, p<0.05)._x000D_ Conclusion: In this study, the most preferred antihypertensive group was drugs_x000D_ acting on RAS, dominated by angiotensin receptor blockers and most preferred_x000D_ drug was metoprolol. Contrary to their comparably deprioritization in recent_x000D_ guidelines, beta-blockers seem to be widely used in this setting. It is understood_x000D_ that the most commonly used drugs do not vary overall in the studied_x000D_ comorbidities of HT.
Objective: Comorbidities are common in hypertension (HT) and determine the_x000D_ management of antihypertensive therapy. We aimed to investigate drug_x000D_ utilization in hypertensive patients in associaition with the presence of other_x000D_ cardiovascular problems._x000D_ Materials and Methods: This retrospective study included data of patients_x000D_ applied to the Turkish Heart Foundation Medical Center between January 2016-_x000D_ June 2018 (n=11,085). Among all medical records (n=26,699), medications,_x000D_ medical and demographic characteristics were evaluated in patients with most_x000D_ common diagnosis: HT, ischemic heart disease (IHD), and dyslipidemia (DL)._x000D_ Data for HT and accompanying IHD and DL were compared._x000D_ Results: 22.2% (n=5,929) of the visits had diagnosis of HT. Of the total 3,601 HT_x000D_ patients, 43.7% (n=1,572) had single diagnosis and 36.7% (n=1,321) had at least_x000D_ one of the two comorbidities. Acetylsalicylic acid was the most common drug in_x000D_ all groups. The most common antihypertensive group was renin-angiotensin_x000D_ system (RAS) blockers and the active molecules were metoprolol and_x000D_ amlodipine. This was followed by “valsartan+hydrochlorothiazide” in HT alone_x000D_ or HT+DL groups and by ramipril in the groups where IHD accompanied. The_x000D_ use of beta-blockers was lower in patients ≥65 years compared to younger_x000D_ patients (13.8% and 16.1%, respectively, p<0.05)._x000D_ Conclusion: In this study, the most preferred antihypertensive group was drugs_x000D_ acting on RAS, dominated by angiotensin receptor blockers and most preferred_x000D_ drug was metoprolol. Contrary to their comparably deprioritization in recent_x000D_ guidelines, beta-blockers seem to be widely used in this setting. It is understood_x000D_ that the most commonly used drugs do not vary overall in the studied_x000D_ comorbidities of HT.