Hagendorff Andreas, Kurz Ira, Müller Alfons, Klebs Sven
Universitätsklinikum Leipzig, Innere Medizin, Fachbereich Kardiologie/Angiologie, LeipzigGermany.
Clinical Research, Kantar Health GmbH, MünchenGermany.
J Drug Assess. 2014 Jan 16;3(1):1-9. doi: 10.3109/21556660.2014.884506. eCollection 2014.
This study evaluated the effectiveness and safety of amlodipine/valsartan/hydrochlorothiazide (A + V + H) single-pill combination therapy in the treatment of hypertensive patients in daily practice.
This prospective, open-label, observational study, enroled adults for whom their physician considered treatment with the single pill combination as indicated. The observational period per patient was ∼3 months. Results were evaluated using basic descriptive statistical methods.
Data of 7132 patients were analyzed. At baseline, the mean blood pressure (BP) was 158.8 ± 17.7 mmHg (systolic, sBP) and 91.5 ± 10.7 mmHg (diastolic, dBP). The most common cardiovascular risk factors were positive family history, dyslipidemia, and diabetes mellitus. The most commonly used daily doses of A + V + H at study end were 5/160/12.5 mg (30.5%) or 10/160/12.5 mg (33.1%). At the last visit mean BP was 135.0 ± 11.8 mmHg (sBP) and 80.2 ± 7.3 mmHg (dBP). The mean BP reduction at last visit compared with baseline was -23.7 ± 17.5 mmHg (sBP) and -11.3 ± 10.6 mmHg (dBP); 43.5% of the patients reached normalization (BP <140/90 mmHg for non-diabetics or <130/80 mmHg for diabetics) and 71.3% reached therapeutic response (sBP <140 or ≥20 mmHg decrease vs baseline and dBP <90 or ≥10 mmHg decrease vs baseline in non-diabetic patients and sBP <130 mmHg or ≥20 mmHg decrease vs baseline and dBP <80 mmHg or ≥10 mmHg decrease vs baseline in patients with diabetes). Adverse events (AEs) were recorded in 2.3% of the patients, the most frequent being peripheral edema (0.6%) and dizziness (0.2%).
In daily practice, A + V + H single-pill treatment effectively lowered the average BP in patients with essential hypertension and was well tolerated.
本研究评估氨氯地平/缬沙坦/氢氯噻嗪(A+V+H)单片复方疗法在日常临床中治疗高血压患者的有效性和安全性。
这项前瞻性、开放标签的观察性研究纳入了医生认为适合接受单片复方治疗的成年人。每位患者的观察期约为3个月。采用基本描述性统计方法评估结果。
分析了7132例患者的数据。基线时,平均血压(BP)为158.8±17.7mmHg(收缩压,sBP)和91.5±10.7mmHg(舒张压,dBP)。最常见的心血管危险因素为家族史阳性、血脂异常和糖尿病。研究结束时最常用的A+V+H每日剂量为5/160/12.5mg(30.5%)或10/160/12.5mg(33.1%)。末次随访时平均血压为135.0±11.8mmHg(sBP)和80.2±7.3mmHg(dBP)。与基线相比,末次随访时平均血压降低值为-23.7±17.5mmHg(sBP)和-11.3±10.6mmHg(dBP);43.5%的患者血压达标(非糖尿病患者血压<140/90mmHg或糖尿病患者血压<130/80mmHg),71.内科学文献翻译3%的患者达到治疗反应(非糖尿病患者收缩压<140mmHg或较基线下降≥20mmHg且舒张压<90mmHg或较基线下降≥10mmHg,糖尿病患者收缩压<130mmHg或较基线下降≥20mmHg且舒张压<80mmHg或较基线下降≥10mmHg)。2.3%的患者记录到不良事件(AE),最常见的是外周水肿(0.6%)和头晕(0.2%)。结论:在日常临床中,A+V+H单片治疗有效降低原发性高血压患者的平均血压,且耐受性良好。