厄贝沙坦治疗高血压患者持续性的决定因素：一项上市后调查结果
Determinants of persistence in hypertensive patients treated with irbesartan: results of a postmarketing survey.
作者信息
Burnier Michel, Hess Bernhard, Greminger Peter, Waeber Bernard
机构信息
Service de Néphrologie, CHUV, Lausanne, Switzerland.
出版信息
BMC Cardiovasc Disord. 2005 Jun 8;5(1):13. doi: 10.1186/1471-2261-5-13.
BACKGROUND
Persistence is a key factor for long-term blood pressure control, which is of high prognostic importance for patients at increased cardiovascular risk. Here we present the results of a post-marketing survey including 4769 hypertensive patients treated with irbesartan in 886 general practices in Switzerland. The goal of this survey was to evaluate the tolerance and the blood pressure lowering effect of irbesartan as well as the factors affecting persistence in a large unselected population.
METHODS
Prospective observational survey conducted in general practices in all regions of Switzerland. Previously untreated and uncontrolled pre-treated patients were started with a daily dose of 150 mg irbesartan and followed up to 6 months.
RESULTS
After an observation time slightly exceeding 4 months, the average reduction in systolic and diastolic blood pressure was 20 (95% confidence interval (CI) -19.6 to -20.7 mmHg) and 12 mmHg (95% CI -11.4 to -12.1 mmHg), respectively. At this time, 26% of patients had a blood pressure < 140/90 mmHg and 60% had a diastolic blood pressure < 90 mmHg. The drug was well tolerated with an incidence of adverse events (dizziness, headaches,...) of 8.0%. In this survey more than 80% of patients were still on irbesartan at 4 month. The most important factors predictive of persistence were the tolerability profile and the ability to achieve a blood pressure target < or = 140/90 mmHg before visit 2. Patients who switched from a fixed combination treatment tended to discontinue irbesartan more often whereas those who abandoned the previous treatment because of cough (a class side effect of ACE-Inhibitors) were more persistent with irbesartan.
CONCLUSION
The results of this survey confirm that irbesartan is effective, well tolerated and well accepted by patients, as indicated by the good persistence. This post-marketing survey also emphasizes the importance of the tolerability profile and of achieving an early control of blood pressure as positive predictors of persistence.
背景
持续性是长期血压控制的关键因素，对于心血管风险增加的患者具有很高的预后重要性。在此，我们展示一项上市后调查的结果，该调查涵盖了瑞士886家普通诊所中接受厄贝沙坦治疗的4769例高血压患者。这项调查的目的是评估厄贝沙坦的耐受性和降压效果，以及在大量未经筛选的人群中影响持续性的因素。
方法
在瑞士所有地区的普通诊所进行前瞻性观察性调查。既往未治疗和未控制的经治疗患者开始接受每日150毫克厄贝沙坦治疗，并随访6个月。
结果
在略超过4个月的观察期后，收缩压和舒张压的平均降低分别为20（95%置信区间（CI）-19.6至-20.7毫米汞柱）和12毫米汞柱（95%CI -11.4至-12.1毫米汞柱）。此时，26%的患者血压<140/90毫米汞柱，60%的患者舒张压<90毫米汞柱。该药物耐受性良好，不良事件（头晕、头痛等）发生率为8.0%。在这项调查中，超过80%的患者在4个月时仍在服用厄贝沙坦。预测持续性的最重要因素是耐受性特征以及在第2次就诊前达到血压目标<或=140/9
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