雷米普利/氨氯地平单片复方制剂——与营养状况相关的降压治疗的有效性、耐受性和患者满意度。

Ramipril/amlodipine single pill - effectiveness, tolerance and patient satisfaction with antihypertensive therapy in relation to nutritional status.

机构信息

Health Promotion and Obesity Management Unit, Department of Pathophysiology Medical University of Silesia, Katowice, Poland.

Pathophysiology Unit, Department of Pathophysiology Medical University of Silesia, Katowice, Poland.

出版信息

Pharmacol Rep. 2014 Dec;66(6):1043-9. doi: 10.1016/j.pharep.2014.06.020. Epub 2014 Jul 9.

DOI:10.1016/j.pharep.2014.06.020

PMID:25443733

Abstract

BACKGROUND

Overweight and obesity decrease the effectiveness of antihypertensive therapy despite the more frequent use of polytherapy. One method for improving therapy effectiveness is by decreasing non-compliance with the use of fixed-dose combinations (FDC). The aim of this study was to assess the effectiveness, tolerance, and satisfaction with ramipril/amlodipine FDC antihypertensive therapy in relation to nutritional status.

METHODS

The survey enrolled 24,240 hypertensive patients recently switched to ramipril/amlodipine FDC (EGIRAMLON) at the same doses as previously prescribed separate pills.

RESULTS

The effectiveness of antihypertensive therapy increased during follow-up from 32.9% to 76.5%. Overweight and obesity were associated with the increased risk of not attaining the recommended BP values [adjusted for age OR=0.74 (95% CI 0.67-0.83) and 0.70 (0.61-0.81) for overweight; 0.54 (0.47-0.60) and 0.49 (0.42-0.57) for obese, at the first and the second examination, respectively]. "Very good" or "good" the FDP tolerance was reported by 98.8%, 97.6% and 96.4%, respectively. Adverse events (AE) were reported in 0.35% of patients regardless of nutritional status. High levels of satisfaction with the FDC were reported by 57.0% of patients with normal weight, 54.5% of overweight, and 50.6% with obesity. Effectiveness and convenience were the most important for patients.

CONCLUSIONS

The effectiveness of therapy with ramipril/amlodipine FDC in the study population was high, but slightly lower in overweigh and obese. This FDC was well tolerated and a significant number of patients satisfied with the therapy regardless of nutritional status. Although the perceived tolerance and satisfaction with treatment were lower in obese and overweight than in normal weight patients; the incidence of AE and perceived benefit from the use of a single-pill, compared to multiple tablets, were comparable irrespective of nutritional status.

摘要

背景

尽管更频繁地使用联合疗法，但超重和肥胖会降低抗高血压治疗的效果。一种提高治疗效果的方法是减少固定剂量复方制剂（FDC）的不依从性。本研究的目的是评估血管紧张素转换酶抑制剂（ACEI）/钙通道阻滞剂（CCB）雷米普利/氨氯地平 FDC 抗高血压治疗与营养状况的疗效、耐受性和满意度。

方法

该研究共纳入 24240 名高血压患者，他们最近被转换为雷米普利/氨氯地平 FDC（EGIRAMLON），剂量与之前开的单片剂量相同。

结果

抗高血压治疗的有效性在随访期间从 32.9%增加到 76.5%。超重和肥胖与未达到推荐血压值的风险增加相关[校正年龄后 OR=0.74（95%CI 0.67-0.83）和 0.70（0.61-0.81），超重；0.54（0.47-0.60）和 0.49（0.42-0.57），第一次和第二次检查]。FDC 的耐受性被报告为“非常好”或“好”的比例分别为 98.8%、97.6%和 96.4%。无论营养状况如何，均有 0.35%的患者报告发生不良事件（AE）。57.0%的体重正常、54.5%的超重和 50.6%的肥胖患者对 FDC 高度满意。对患者而言，有效性和便利性是最重要的。