Section of Pharmacology, University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, 54000, Pakistan.
Section of Pharmaceutics, University of the Punjab, Allama Iqbal Campus, Lahore, 54000, Pakistan.
BMC Womens Health. 2020 Aug 1;20(1):161. doi: 10.1186/s12905-020-01033-2.
Gender wise differences exist in anti-hypertensive treatment outcomes, yet still un-explored in Pakistan. Thus, we aimed to estimate the clinical efficacy of four different anti-hypertensive regimens in hypertensive women of Punjab, Pakistan.
A longitudinal cohort study of 12 months duration was conducted by enrolling 300 hypertensive women on four anti-hypertensive regimens. Chi-square for significance, logistic regression for association and multilevel regression for changes in outcomes were used.
Majority of subjects were < 60 years of age, weighing > 65 Kg, having family history, married and hailing from urban areas, with diabetes as the most common comorbidity. Hypertension, adjusted for covariates, was significantly associated with salt intake (OR:2.27, p < 0.01) and physical activity (OR;2.16, p < 0.01). High-risk subjects, compared to low-risk, were consuming more fat (OR;1.54), meat (OR; 2), salt (OR; 2.48) and even vegetables/fruits (OR;3.43). Compared to baseline, the maximum reduction in BP was observed with combination therapy, N-GITS+LTN + HCT (SBP; - 50.17, p < 0.01, DBP; - 16.55, p < 0.01), followed by N-GITS alone (SBP; - 28.89, p < 0.01, DBP; - 12.21, p < 0.01). Compared to baseline, adjusted for treatment effects, significant reductions in SBP (low-risk; - 17.92, p < 0.01 high-risk; - 19.48, p < 0.01) and DBP (low-risk; - 17.92, p < 0.01, high-risk; - 19.48, p < 0.01) were observed in low and high risk patients. Among all four cohorts, orthostatic hypotension and edema were common in N-GITS+LTN + HCT only, but variable effects were observed on biochemical values; urea, BSR and creatinine.
In conclusion, compared to a single agent, combination therapy conferred improved BP controls followed by N-GITS alone in low and high risk women with manageable side effects.
在抗高血压治疗结果方面存在性别差异，但在巴基斯坦仍未得到探索。因此，我们旨在评估四种不同抗高血压方案在巴基斯坦旁遮普省高血压女性中的临床疗效。
这是一项为期 12 个月的纵向队列研究，共纳入 300 名接受四种抗高血压方案治疗的高血压女性。使用卡方检验进行显著性检验，使用逻辑回归进行关联分析，使用多水平回归进行结果变化分析。
大多数受试者年龄<60 岁，体重>65 公斤，有家族史，已婚，来自城市地区，最常见的合并症是糖尿病。调整协变量后，高血压与盐摄入量（OR：2.27，p<0.01）和体力活动（OR：2.16，p<0.01）显著相关。与低危组相比，高危组摄入更多的脂肪（OR：1.54）、肉类（OR：2）、盐（OR：2.48）甚至蔬菜/水果（OR：3.43）。与基线相比，联合治疗（N-GITS+LTN+HCT）使血压最大程度下降（SBP：-50.17，p<0.01，DBP：-16.55，p<0.01），其次是 N-GITS 单药治疗（SBP：-28.89，p<0.01，DBP：-12.21，p<0.01）。与基线相比，调整治疗效果后，低危组 SBP（-17.92，p<0.01）和高危组 SBP（-19.48，p<0.01）和 DBP（-17.92，p<0.01，高危组；-19.48，p<0.01）均显著降低。在所有四组中，仅 N-GITS+LTN+HCT 会引起体位性低血压和水肿，但对生化值（尿素、BSR 和肌酐）的影响不同。
总之，与单一药物相比，联合治疗在低危和高危女性中提供了更好的血压控制，其次是 N-GITS 单药治疗，且副作用可管理。
