Heaton Joseph, Johal Anmol, Alshami Abbas, Okoh Alexis, Udongwo Ndausung, Schoenfeld Matthew, Saybolt Matthew, Almendral Jesus, Sealove Brett
Department of Medicine Jersey Shore University Medical Center Neptune City NJ USA.
Division of Cardiology Jersey Shore University Medical Center Neptune City NJ USA.
J Am Heart Assoc. 2024 Dec 3;13(23):e036046. doi: 10.1161/JAHA.124.036046. Epub 2024 Nov 27.
Hypertension is a global health issue causing increased cardiovascular morbidity and mortality. Adherence to prescribed medication is a crucial factor in obtaining targeted outcomes, and fixed-dose combined antihypertensive pills (FCAPs) have been shown to help combat difficulties associated with polypharmacy management. This study investigated the influence of combination antihypertensives on blood pressure (BP) management.
Data from the 2013 to 2020 NHANES (National Health and Nutrition Examination Survey) were analyzed. Participants were included if between 18 and 79 years of age and were prescribed 2 antihypertensive classes. BP was deemed controlled if <140/<90 mm Hg. Examiner documentation and questionnaire data determined prescription antihypertensive medication usage and the presence of an FCAP. Descriptive statistics and multivariate regression analyses were used to compare the 2 groups. Subgroup analysis was performed for stricter BP goals of <130/<80 mm Hg. A total of 15 927 747 weighted participants met the inclusion criteria, 32.7% of whom were undergoing management with an FCAP. Participants with an FCAP were 1.78 (95% CI, 1.28-2.47, =0.001) times more likely to have controlled BP (76.4% versus 67.3%) than those without an FCAP. Subgroup analysis revealed that FCAPs were associated with stricter BP goals (odds ratio [OR], 1.65, =0.008; 87.6% versus 71.2%) compared with those without.
Participants with an FCAP were more likely to exhibit controlled BP, including participants with clinical atherosclerotic cardiovascular disease and those targeting stricter control. Clinicians can immediately and meaningfully affect their patient's BP by opting for FCAPs.
高血压是一个全球性的健康问题，会导致心血管疾病的发病率和死亡率上升。坚持服用处方药是实现目标治疗效果的关键因素，而固定剂量复方降压药（FCAPs）已被证明有助于应对与多药治疗管理相关的困难。本研究调查了复方降压药对血压管理的影响。
分析了2013年至2020年美国国家健康与营养检查调查（NHANES）的数据。纳入年龄在18至79岁之间且被开具两种降压药的参与者。如果血压<140/<90 mmHg，则认为血压得到控制。通过检查人员记录和问卷调查数据确定处方降压药的使用情况以及是否使用了FCAP。采用描述性统计和多变量回归分析对两组进行比较。针对更严格的血压目标<130/<80 mmHg进行了亚组分析。共有15927747名加权参与者符合纳入标准，其中32.7%正在使用FCAP进行治疗。与未使用FCAP的参与者相比，使用FCAP的参与者血压得到控制的可能性高1.78倍（95%置信区间，1.28 - 2.47，P = 0.001）（分别为76.4%和67.3%）。亚组分析显示，与未使用FCAP的参与者相比，FCAP与更严格的血压目标相关（优势比[OR]，1.65，P = 0.008；分别为87.6%和71.2%）。
使用FCAP的参与者更有可能实现血压控制，包括患有临床动脉粥样硬化性心血管疾病的参与者以及目标是更严格控制血压的参与者。临床医生选择FCAP可以立即并显著影响患者的血压。
