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影响高血压患者降压药物变化的因素。

Factors affecting the changes in antihypertensive medications in patients with hypertension.

作者信息

Chung Tae Kyu, Jeon Yoomin, Hong YeSol, Hong Suyeon, Moon Jun Sik, Lee Howard

机构信息

Department of Applied Bioengineering, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.

Center for Convergence Approaches in Drug Development, Seoul, South Korea.

出版信息

Front Cardiovasc Med. 2022 Sep 30;9:999548. doi: 10.3389/fcvm.2022.999548. eCollection 2022.

Abstract

As frequent changes in anti-hypertensive (HTN) medications may reduce adherence to the treatments, identifying modifiable factors leading to changes in anti-HTN medications can help clinicians optimize treatment strategies for individual patients. We performed this study to explore the pattern of anti-HTN medications and to identify factors that are associated with the changes in anti-HTN medications. To this end, we used a clinical database of Seoul National University Hospital, extracted, transformed, and loaded by the observational medical outcomes partnership common data model. Demographic and all recorded clinical diagnoses, medications, and procedures data of eligible subjects were collected. Of 636 subjects who were eligible for this study, 297 subjects with a record of ≥1 anti-HTN medication changes and other 297 subjects without a record of medication change were selected for the study population. High diastolic blood pressure (adjusted odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.001-1.040, = 0.040), arrhythmia (adjusted OR: 10.01, 95% CI: 1.86-185.57, = 0.030), and angina pectoris with antianginal agents (adjusted OR: 4.85, CI: 1.05-23.89, = 0.046) were associated with the changes in anti-HTN medications, indicating that any patients with these covariates require additional attention to reduce the likelihood of changing anti-HTN medications.

摘要

由于抗高血压(HTN)药物的频繁更换可能会降低治疗依从性,识别导致抗HTN药物更换的可改变因素有助于临床医生为个体患者优化治疗策略。我们开展这项研究以探索抗HTN药物的使用模式,并识别与抗HTN药物更换相关的因素。为此,我们使用了首尔国立大学医院的临床数据库,该数据库由观察性医疗结局合作组织通用数据模型提取、转换和加载。收集了符合条件受试者的人口统计学数据以及所有记录的临床诊断、用药和手术数据。在636名符合本研究条件的受试者中,选择了297名有≥1次抗HTN药物更换记录的受试者和另外297名无药物更换记录的受试者作为研究人群。高舒张压(调整后的优势比[OR]:1.02,95%置信区间[CI]:1.001 - 1.040,P = 0.040)、心律失常(调整后的OR:10.01,95%CI:1.86 - 185.57, P = 0.030)以及使用抗心绞痛药物治疗的心绞痛(调整后的OR:4.85,CI:1.05 - 23.89,P = 0.046)与抗HTN药物更换相关,这表明任何有这些协变量的患者需要额外关注以降低更换抗HTN药物的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b5f/9561640/bf07bc386f0a/fcvm-09-999548-g0001.jpg

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