Paz Marco A, Farrerons Monica, Saez Marc, Saurina Carme, Pinto Marc Garcia, Castro Sonia, Sobrino Javier, de Tuero Gabriel Coll
Hospital de Santa Caterina, Girona.
Department of Medical Sciences, University of Girona, Girona.
Medicine (Baltimore). 2019 Apr;98(15):e15010. doi: 10.1097/MD.0000000000015010.
The response to antihypertensive drugs is predictable. The absence of precise prescription recommendations to treat arterial hypertension (HT) lead to use drugs unable to reduce blood pressure (BP) to target values.We published ATOM study, in which we found significant differences in the ability to reduce BP between the different drugs.The objective of the study was to determine the expected decrease in blood pressure with the use of commercialized doses of the drugs commonly used in the treatment of HT in clinical practice, to avoid the use of drugs or combinations that even with the best response, are unable to obtain the necessary BP decrease to reach the goal.
The analysis was based on the results of the ATOM study. To convert the mean doses of the different drugs and combinations in commercialized doses, the conclusions of the study by Law et al have been applied.
Based on the results, two tables were drawn, one for systolic BP and the other for diastolic BP, where the doses of the different drugs and combinations are classified according to the BP decrease that can be expected from them. In order to favor the use of the tables in clinical practice, the different drugs have been grouped in intervals of 10 millimeters of mercury (mmHg) for the decrease of the systolic BP and of 5 mmHg for the diastolic BP.
Recommendations for the use of antihypertensive treatments should not be limited to pharmacological families. They should also consider differences between drugs or specific combinations. From the data of the ATOM study we have implemented tables that express the effect of the drugs commonly used in clinical practice and that should allow the clinicians to choose with care the treatment to use.
抗高血压药物的反应是可预测的。缺乏用于治疗动脉高血压（HT）的精确处方建议导致使用无法将血压（BP）降至目标值的药物。我们发表了ATOM研究，其中我们发现不同药物在降低血压的能力上存在显著差异。本研究的目的是确定在临床实践中使用治疗HT常用药物的商业化剂量时预期的血压下降情况，以避免使用即使有最佳反应也无法实现必要的血压下降以达到目标的药物或药物组合。
分析基于ATOM研究的结果。为了将不同药物和药物组合的平均剂量转换为商业化剂量，应用了Law等人的研究结论。
根据结果绘制了两个表格，一个用于收缩压，另一个用于舒张压，其中不同药物和药物组合的剂量根据预期的血压下降情况进行分类。为了便于在临床实践中使用这些表格，不同药物按收缩压下降10毫米汞柱（mmHg）和舒张压下降5 mmHg的间隔进行分组。
抗高血压治疗的使用建议不应仅限于药理学类别。还应考虑药物或特定组合之间的差异。根据ATOM研究的数据，我们制定了表格，这些表格显示了临床实践中常用药物的效果，应能让临床医生谨慎选择要使用的治疗方法。
