Ogudu Ugochinyere, Nwaiwu Obiyo, Fasipe Olumuyiwa John
Department of Pharmacology, Therapeutics & Toxicology, Faculty of Basic Medical Sciences, University of Lagos, Idi-Araba, Lagos State, Nigeria.
Department of Pharmacology & Therapeutics, Faculty of Basic Clinical Sciences, University of Medical Sciences, Ondo City, Ondo State, Nigeria.
Int J Cardiol Cardiovasc Risk Prev. 2022 Aug 5;14:200144. doi: 10.1016/j.ijcrp.2022.200144. eCollection 2022 Sep.
Antihypertensive drugs administered as fixed dose combination (FDC) therapy compared to separately administered combination therapy have been proposed to improve treatment compliance/adherence, and therefore the efficacy of blood pressure (BP) control treatment.
The aim of this present study is to compare the blood pressure control, renal end-organ protection and medication compliance/adherence in patients receiving FDC and those receiving separately administered combinations of Lisinopril and Hydrochlorothiazide in treatment-naive hypertensive adult patients in a rural Nigerian community.
ology: This randomized two-arm prospective longitudinal 8-week parallel-group study was carried-out for 6-month at the Ajegunle Community between April 2018 and October 2018. Efficacy variables included the changes from baseline in mean sitting systolic BP (MSSBP) and mean sitting diastolic BP (MSDBP). Medication safety, compliance/adherence and renal end-organ protection were assessed.
The baseline characteristics of the two groups were similar. Prevalence of hypertension was found to be 32.9%. The mean blood pressure of all the participants was 165.6 ± 16.5 mmHg and 98.5 ± 11.5 mmHg for systolic BP and diastolic BP respectively, while the mean pulse rate of the participants was 85.0 ± 13.4 beats/min. At the 8-week end point, both regimens had achieved significant reductions from baseline in MSSBP (-33.18 and -37.16 mm Hg, respectively; both, P < 0.05) and MSDBP (-12.97 and -17.53 mm Hg; both, P < 0.05). Both regimens were generally well tolerated. Adherence was better in the FDC arm and there was no any reported case of proteinuria occurrence in both arms.
The high prevalence of hypertension in the community shows that there is unmet need in diagnosis and awareness of the disease. Both combination therapies were well tolerated; but the FDC antihypertensive therapy resulted in statistically significant amount of BP reductions than the separately administered combination antihypertensive therapy. Making FDCs available and affordable will help many hypertensive patients to achieve their target BP control goals easily.
与单独给药的联合治疗相比，采用固定剂量复方制剂（FDC）疗法给药的抗高血压药物已被认为可提高治疗依从性，从而提高血压（BP）控制治疗的疗效。
本研究旨在比较在尼日利亚农村社区初治高血压成年患者中，接受FDC治疗的患者与接受赖诺普利和氢氯噻嗪单独给药联合治疗的患者的血压控制情况、肾脏终末器官保护情况及药物依从性/服药依从性。
本随机双臂前瞻性纵向8周平行组研究于2018年4月至2018年10月在阿杰古勒社区进行了6个月。疗效变量包括平均坐位收缩压（MSSBP）和平均坐位舒张压（MSDBP）相对于基线的变化。评估了药物安全性、依从性/服药依从性和肾脏终末器官保护情况。
两组的基线特征相似。高血压患病率为32.9%。所有参与者的平均血压，收缩压为165.6±16.5 mmHg，舒张压为98.5±11.5 mmHg，而参与者的平均脉搏率为85.0±13.4次/分钟。在8周终点时，两种治疗方案的MSSBP（分别为-33.18和-37.16 mmHg；均P<0.05）和MSDBP（-12.97和-17.53 mmHg；均P<0.05）较基线均有显著降低。两种治疗方案总体耐受性良好。FDC组的依从性更好，且两组均未报告蛋白尿发生病例。
该社区高血压的高患病率表明，在疾病诊断和认知方面存在未满足的需求。两种联合治疗方案耐受性良好；但FDC抗高血压治疗导致的血压降低在统计学上比单独给药的联合抗高血压治疗更显著。使FDC可得且价格可承受将有助于许多高血压患者轻松实现其血压控制目标。
