Prevalence and real-world assessment of central aortic blood pressure in adult patients with essential hypertension uncontrolled on single anti-hypertensive agents
| Autor: | Ranjan Kumar Sharma, Ravi M. Tiwari, Abhay Joshi, Manish Verma, Chirag Trivedi, Deepa Chodankar |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
030204 cardiovascular system & hematology Essential hypertension V2 Visit 2 0302 clinical medicine Clinical endpoint Prevalence 030212 general & internal medicine Prospective Studies Prospective cohort study Real-world study Middle Aged PP per-protocol Drug class DHP-CCB dihydropyridine calcium channel blockers Hypertension Aortic pressure Female Essential Hypertension Cardiology and Cardiovascular Medicine circulatory and respiratory physiology Adult medicine.medical_specialty RD1-811 Diastole India DBP diastolic blood pressure ADR adverse drug reaction BBP brachial blood pressure 03 medical and health sciences CAP central aortic pressure Internal medicine Brachial blood pressure medicine Diseases of the circulatory (Cardiovascular) system Humans Arterial Pressure cardiovascular diseases FDC fixed-dose combination Antihypertensive Agents Aged business.industry SBP systolic blood pressure LCD low ceiling diuretics V1 Visit 1 ACEI angiotensin converting enzyme inhibitors medicine.disease ARB angiotensin II receptor blockers CI confidence interval Blood pressure RC666-701 Central aortic pressure Observational study Surgery Clinical and Preventive Cardiology BB beta-blockers business Follow-Up Studies |
| Zdroj: | Indian Heart Journal Indian Heart Journal, Vol 70, Iss, Pp S213-S220 (2018) |
| ISSN: | 0019-4832 |
| Popis: | Objective: To assess the prevalence of high central aortic pressure (CAP) in Indian patients with uncontrolled essential hypertension while on anti-hypertensive monotherapy. Also, to determine correlation between brachial blood pressure (BBP) and CAP, and ascertain if it is impacted by anti-hypertensive drug class and patients’ age. Methods: In this real-world, observational, prospective study, patients (30–70 years) with uncontrolled BBP (systolic BP [SBP] ≥140 mmHg or diastolic BP [DBP] ≥90 mmHg) were enrolled. Treatment was adjusted at Visit 1 (baseline), based on BBP and at treating physicians’ discretion. Primary endpoint was proportion of patients with uncontrolled central aortic SBP (>125 mmHg) at baseline. Secondary endpoints were comparison of BBP and CAP across drugs classes and age groups at baseline and Visit 2 (End-of-study, ∼8 weeks post-baseline), and proportion of patients with uncontrolled central SBP at end-of-study. Results: Of 2030 patients screened, 1949 patients reported at baseline and 1740 patients completed end-of-study visit. Central SBP was >125 mmHg for 84.3% patients at baseline, and 48% patients at end-of-study. Interestingly, at end-of-study, 6.6% patients still had uncontrolled brachial SBP and controlled central SBP, while 13.6% patients had uncontrolled central SBP and controlled brachial SBP. At both visits, brachial SBP and central SBP showed positive correlation across most drug classes and age groups. At baseline, ACE inhibitors showed better efficacy than other drug classes. At end-of-study, BP control was better with fixed-dose combinations, though free–drug combinations were more frequently prescribed. Conclusion: Measurement of CAP along with BBP can be vital in management of hypertension. Ctri registration number: CTRI/2015/10/006302. Keywords: Brachial blood pressure, Central aortic pressure, Hypertension, India, Real-world study |
| Databáze: | OpenAIRE |
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