BackgroundChanges in antihypertensive drug treatment are paramount in the adequate management of patients with hypertension, still, there is little information regarding changes in antihypertensive drug treatment in Switzerland. Our aim was to assess those changes and associated factors in a population-based, prospective study.MethodsData from the population-based, CoLaus study, conducted among subjects initially aged 35–75 years and living in Lausanne, Switzerland. 772 hypertensive subjects (371 women) were followed for a median of 5.4 years. Data Subjects were defined as continuers (no change), switchers (one antihypertensive class replaced by another), combiners (one antihypertensive class added) and discontinuers (stopped treatment). The distribution and the factors associated with changes in antihypertensive drug treatment were assessed.ResultsDuring the study period, the prescription of diuretics decreased and of ARBs increased: at baseline, diuretics were taken by 46.9% of patients; angiotensin receptor blockers (ARB) by 44.7%, angiotensin converting enzyme inhibitors (ACEI) by 28.8%, beta-blockers (BB) by 28.0%, calcium channel blockers (CCB) by 18.9% and other antihypertensive drugs by 0.3%. At follow-up (approximately 5 years later), their corresponding percentages were 42.8%, 51.7%, 25.5%, 33.0% 20.7% and 1.0%. Among all participants, 54.4% (95% confidence interval: 50.8-58.0) were continuers, 26.9% (23.8-30.2) combiners, 12.7% (10.4-15.3) switchers and 6.0% (4.4-7.9) discontinuers. Combiners had higher systolic blood pressure values at baseline than the other groups (p < 0.05). Almost one third (30.6%) of switchers and 29.3% of combiners improved their blood pressure status at follow-up, versus 18.8% of continuers and 8.7% of discontinuers (p < 0.001). Conversely, almost one third (28.3%) of discontinuers became hypertensive (systolic ≥140 mm Hg or diastolic ≥90 mm Hg), vs. 22.1% of continuers, 16.3% of switchers and 11.5% of combiners (p < 0.001). Multivariate analysis showed baseline uncontrolled hypertension, ARBs, drug regimen (monotherapy/polytherapy) and overweight/obesity to be associated with changes in antihypertensive therapy.ConclusionIn Switzerland, ARBs have replaced diuretics as the most commonly prescribed antihypertensive drug. Uncontrolled hypertension, ARBs, drug regimen (monotherapy or polytherapy) and overweight/obesity are associated with changes in antihypertensive treatment.

Magnesiocard® (formes orales)C: Magnesii aspartatis hydrochloridum trihydricum. I: Carence en magnésium, troubles du rythme cardiaque, besoins accrus liés à la pratique sportive de haut niveau et pendant la grossesse, éclampsie et pré-éclampsie, tétanie, crampes dans les mollets, myoclonies, jambes sans repos (restless legs). P: De 4.5 mg (= 0.185 mmol) à 9 mg (= 0.37 mmol) de magnésium par kg de poids corporel / 10 -20 mmol de magnésium par jour, en 1 -3 prises orales selon la forme d'administration (granulés, comprimés effervescents, comprimés pelliculés). CI: Hypersensibilité à l'un des composants du médicament. P: Insuffisance rénale. Il est indispensable de surveiller la concentration sérique de magnésium chez les insuffisants rénaux. Magnesiocard 7.5 mmol: ne pas utiliser en cas de phénylcétonurie. IA: Les tétracyclines et Magnesiocard devraient être pris à 3 -4 heures d'intervalle (inhibition mutuelle au niveau de l'absorption). Tendance à l'hypercalcémie lors de l'administration concomitante de magnésium et de cholécalciférol. G/A: Peut être administré. EI: Occasionnellement: troubles gastro-intestinaux. E: Comprimés pelliculés (2.5 mmol) 50, 100; granulés (5 mmol) citron et granulés (5 mmol) orange 20*, 50*; comprimés effervescents (7.5 mmol) 20*, 60*; granulés (10 mmol) grapefruit et granulés (10 mmol) orange 20*, 50*. Cat. B. Pour des informations détaillées, voir www.swissmedicinfo.ch. *admis par les caisses-maladie V030820 Références: 1: www.swissmedicinfo.ch, consulté le 15.10.2020.