Novel stratified medicines approach to manage uncontrolled hypertension due to multiple drug intolerances
| Autor: | Melvin D. Lobo, Catherine Schuster Bruce, Gurvinder Rull, Antoniou Sotiris |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Drug
Male medicine.medical_specialty Referral media_common.quotation_subject Drug intolerance Blood Pressure 030204 cardiovascular system & hematology Left ventricular hypertrophy Administration Cutaneous Clonidine 03 medical and health sciences 0302 clinical medicine Intolerances Internal medicine medicine Humans 030212 general & internal medicine Antihypertensive Agents Novel Treatment (New Drug/Intervention Established Drug/Procedure in New Situation) media_common Transdermal clonidine business.industry Disease Management General Medicine Guideline Middle Aged medicine.disease Blood pressure Hypertension Drug Therapy Combination business |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A 61-year-old man with a 30-year history of uncontrolled hypertension was unable to tolerate conventional antihypertensive medications from all classes. At the time of referral to our centre he had discontinued all antihypertensive drugs and felt well. However, his average home blood pressure (HBP) reading was 179/125 mm Hg and echocardiography demonstrated moderate concentric left ventricular hypertrophy. A novel stratified medicines algorithm was used to guide treatment entailing transdermal clonidine patch therapy instead of tablet formulations. Sixteen months later, his average HBP was 147/106 mm Hg with no side effects and the left ventricular hypertrophy had completely regressed. Our experience has taught us that multiple drug intolerance is a common, often overlooked, cause of non-adherence to antihypertensive medication. This case demonstrates the benefit of a novel approach to optimise blood pressure control and emphasises the important role of hypertension specialists in managing complex, high-risk patients unable to tolerate guideline-based therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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