Marques da Silva Pedro, Haag Uwe, Guest Julian F, Brazier John E, Soro Marco
Arterial Investigation Unit, Medicine 4, Santa Marta's Hospital, CHLC, Lisbon, Portugal.
HaaPACS GmbH, Schriesheim, Germany.
Health Qual Life Outcomes. 2015 Feb 21;13:24. doi: 10.1186/s12955-015-0216-6.
A post-hoc analysis was performed on the data from a 54 weeks phase III study (ClinicalTrials.gov identifier: NCT00923091) to measure changes in the health-related quality of life (HRQoL) of 2,690 patients aged ≥18 with moderate-to-severe hypertension who received one of six doses of olmesartan/amlodipine/hydrochlorothiazide (OLM/AML/HCTZ), using the MINICHAL and EQ-5D instruments.
Descriptive statistics were used to assess blood pressure and HRQoL scores over the study period. Analysis of covariance (ANCOVA) was used to identify those factors that could possibly have influenced HRQoL. Linear regression was used to assess the relationship between changes in blood pressure and HRQoL scores.
Patients' baseline MINICHAL mood and somatic domains scores were 5.5 and 2.6. Over the study period HRQoL improved as both MINICHAL scores decreased by 31-33%. Patients' baseline EQ-5D index and VAS scores were 0.9 and 73.4 respectively, increasing by 6% and 12% over the study period. Patients' QALY gain over the 54 weeks study period was estimated to be 0.029 QALYs. The ANCOVA showed that changes in patients' HRQoL was likely to have been influenced by patients' achievement of blood pressure control, the amount of concomitant medication and patients' last used dosage strength of antihypertensive. Linear regression showed that blood pressure improvement may have been associated with improved HRQoL.
This study showed that OLM/AML/HCTZ reduced blood pressure and significantly increased blood pressure control whilst improving patients' HRQoL. Achieving blood pressure control, amount of concomitant medication and dosage strength of antihypertensive impacted on patients' HRQoL.
对一项为期54周的III期研究(ClinicalTrials.gov标识符:NCT00923091)的数据进行事后分析,以测量2690例年龄≥18岁的中重度高血压患者使用MINICHAL和EQ-5D工具接受六种剂量的奥美沙坦/氨氯地平/氢氯噻嗪(OLM/AML/HCTZ)之一后的健康相关生活质量(HRQoL)变化。
使用描述性统计评估研究期间的血压和HRQoL评分。采用协方差分析(ANCOVA)确定可能影响HRQoL的因素。使用线性回归评估血压变化与HRQoL评分之间的关系。
患者的基线MINICHAL情绪和躯体领域评分分别为5.5和2.6。在研究期间,随着MINICHAL评分均下降31%-33%,HRQoL得到改善。患者的基线EQ-5D指数和VAS评分分别为0.9和73.4,在研究期间分别增加了6%和12%。估计患者在54周研究期间的质量调整生命年(QALY)增益为0.029 QALY。ANCOVA显示,患者HRQoL的变化可能受到患者血压控制的实现情况、合并用药量以及患者最后使用的抗高血压药物剂量强度的影响。线性回归显示,血压改善可能与HRQoL改善相关。
本研究表明,OLM/AML/HCTZ可降低血压并显著提高血压控制率,同时改善患者的HRQoL。实现血压控制、合并用药量和抗高血压药物剂量强度对患者的HRQoL有影响。