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Objective. To assess the characteristics of antihypertensive therapy (AHT) in outpatient patients in relation to comorbidities and multimorbidity level. Design and methods. A cross-sectional study included 140 patients with diagnosed hypertension (HTN). We performed a standardized complaints and medical history registration, questionnaire survey, anthropometry, office blood pressure (BP) assessment. Based on Charlson index the patients were divided into 2 groups: group 1 with moderate multimorbidity (≤ 4 points), group 2 with high multimorbidity level (≥ 5 points). The data are presented as median and proportions with bi-directional 95 % confidence interval. Results. In the sampling of 100 (64,3 71,4 78,6 %) women and 40 (21,4 28,6 35,7 %) men median age was 65 68 70, median Charlson index was 4 5 5. Group with moderate multimorbidity included 63 patients. High multimorbidity group included 77 subjects. HTN degree did not differ between the groups. Subjects from group 2 had higher level of cardiovascular risk (χ2 = 17,2, df = 2, p = 0,00018) and were more likely to have a history of HTN-associated clinical conditions (χ2 = 27,1, df = 2, p = 0,00000). By the time of examination, AHT was started in 137 (95,097,9 100,0%) patients. Monotherapy was ongoing in 20 cases (8,814,3 20,4%), combined AHT was prescribed to 117 (79,6 85,4 91,2 %) persons: 50 (21,2 36,5 43,8 %) patients received 2 drugs, 67 (40,9 48,9 56,9 %) patients received ≥ drugs. Number of antihypertensive drugs was higher in patients of group 2 than in group 1 (χ2 = 6,7, df = 2, p = 0,036). Drug number was not associated with HTN degree (χ2 = 3,8, df = 4, p = 0,44). Patients from group 2 were more likely to take β1-blockers (p = 0,027) and moxonidine (p = 0,042). Non-steroid anti-inflammatory drugs (NSAIDs) reduced the frequency of achieving the target BP level in patients treated by angiotensin converting enzyme inhibitors (p = 0,002). The frequency of achieving target BP was 42,9 50,7 58,6 %, it was independent of the number of prescribed drugs (p = 0,07) and did not differ in the groups of moderate and high multimorbidity (p = 0,87). Conclusions. Multimorbid patients require combined antihypertensive drugs to control hypertension. Multimorbidity level, comorbidities and drug-to-drug interactions should be taken into account during individualized HTN management. NSAID significantly affect the effectiveness of antihypertensive therapy.
Objective. To assess the characteristics of antihypertensive therapy (AHT) in outpatient patients in relation to comorbidities and multimorbidity level. Design and methods. A cross-sectional study included 140 patients with diagnosed hypertension (HTN). We performed a standardized complaints and medical history registration, questionnaire survey, anthropometry, office blood pressure (BP) assessment. Based on Charlson index the patients were divided into 2 groups: group 1 with moderate multimorbidity (≤ 4 points), group 2 with high multimorbidity level (≥ 5 points). The data are presented as median and proportions with bi-directional 95 % confidence interval. Results. In the sampling of 100 (64,3 71,4 78,6 %) women and 40 (21,4 28,6 35,7 %) men median age was 65 68 70, median Charlson index was 4 5 5. Group with moderate multimorbidity included 63 patients. High multimorbidity group included 77 subjects. HTN degree did not differ between the groups. Subjects from group 2 had higher level of cardiovascular risk (χ2 = 17,2, df = 2, p = 0,00018) and were more likely to have a history of HTN-associated clinical conditions (χ2 = 27,1, df = 2, p = 0,00000). By the time of examination, AHT was started in 137 (95,097,9 100,0%) patients. Monotherapy was ongoing in 20 cases (8,814,3 20,4%), combined AHT was prescribed to 117 (79,6 85,4 91,2 %) persons: 50 (21,2 36,5 43,8 %) patients received 2 drugs, 67 (40,9 48,9 56,9 %) patients received ≥ drugs. Number of antihypertensive drugs was higher in patients of group 2 than in group 1 (χ2 = 6,7, df = 2, p = 0,036). Drug number was not associated with HTN degree (χ2 = 3,8, df = 4, p = 0,44). Patients from group 2 were more likely to take β1-blockers (p = 0,027) and moxonidine (p = 0,042). Non-steroid anti-inflammatory drugs (NSAIDs) reduced the frequency of achieving the target BP level in patients treated by angiotensin converting enzyme inhibitors (p = 0,002). The frequency of achieving target BP was 42,9 50,7 58,6 %, it was independent of the number of prescribed drugs (p = 0,07) and did not differ in the groups of moderate and high multimorbidity (p = 0,87). Conclusions. Multimorbid patients require combined antihypertensive drugs to control hypertension. Multimorbidity level, comorbidities and drug-to-drug interactions should be taken into account during individualized HTN management. NSAID significantly affect the effectiveness of antihypertensive therapy.
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