Factors Associated with Masked Uncontrolled Arterial Hypertension in Patients Receiving Antihypertensive Treatment
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Abstract
The aim of the study: to determine the frequency of the identify using a home blood pressure measurement (BP) masked uncontrolled arterial hypertension (MUAH), its sustainability and its associated factors at different stages algorithmization antihypertensive therapy on the basis of a fixed combination of perindopril and amlodipine in patients with uncomplicated hypertension.
Materials and methods. In an open prospective study were included 501 patients aged from 35 to 75 years (mean age 58,0±9.5 years). Of these, 221 cases (44.1%) patients with uncomplicated essential AH with AO ≥160/100 mm Hg (in individuals not previously treated) or ≥140/90 mm Hg in the case of the previously assigned antihypertensive therapy. The research design included a period of 6 months 6 visits: 7 days, 1, 2, 3 and 6 months. Step1by1step algorithm for the treatment of patients was provided for the appointment of a fixed combination of perindopril and amlodipine, consecutive appointment, if necessary, indapamide retard, spironolactone, moxonidine or doxazosin to achieve the target office BP.
Results. It was found that the proposed algorithm treatment not only gives the opportunity for 6 months to achieve therapeutic goals relative to the target level of office BP in 78.9% of patients, but in 56,8% decrease among them the percentage of persons with the MUAH.
Conclusion. According to the home definition of BP at different stages of antihypertensive therapy MUAH inherent to 23.5–51.6% of patients with controlled office AO and later persists not less than one-third of patients. Algorithmization antihypertensive therapy on the basis of a fixed combination of perindopril and amlodipine allows reducing the percentage of patients with MN of hypertension among patients with target office BP at 56.8 per cent for 6 months of treatment.
##plugins.themes.bootstrap3.article.details##
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright and grant the journal the first publication of original scientific articles under the Creative Commons Attribution 4.0 International License, which allows others to distribute work with acknowledgment of authorship and first publication in this journal.
References
Mancia G., Fagard R., Narkiewicz K. et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) // Journal of Hypertension. – 2013. – Vol. 31. – P. 1281-1357.
Keenan K., Hayen A., Neal B.C, Irwig L. Long term monitoring in patients receiving treatment to lower blood pressure: analysis of data from placebo controlled randomized controlled trial // BMJ. – 2009. – Vol. 338. – P. b1492.
Reino-González S., Pita-Fernández S., Cibiriain-Sola M. et al. Validity of clinic blood pressure compared to ambulatory monitoring in hypertensive patients in a primary care setting // Blood Pressure. – 2015. – Vol. 24 (2). – P. 111-118.
Franklin S.S., O’Brien E., Thijs L. et al. Masked Hypertension A Phenomenon of Measurement // Hypertension. – 2015. – Vol. 65. – P. 16-20.
Franklin SS, Thijs L, Li Y, et al. International Database on Ambulatory blood pressure in Relation to Cardiovascular Outcomes Investigators. Masked hypertension in diabetes mellitus: treatment implications for clinical practice // Hypertension. – 2013. – Vol. 61. – P. 964-971.
Sivén S.S.E., Niiranen T.J., Kantola I.M. et al. White-coat and masked hypertension as risk factors for progression to sustained hypertension: the Finn Home study // Journal of Hypertension. – 2016. – Vol. 34. – P. 54-60.
Cacciolati C., Hanon O., Alperovitch A. et al. Risk of sustained hypertension in masked and white-coat hypertension: a follow up study of an elderly community based cohort // Journal of Hypertension. – 2011. – Vol. 29. – P. e294-e295.
Sobrino J, Domenech M, Camafort M, Vinyoles E, Coca A; investigadores del grupo ESTHEN [Prevalence of masked hypertension in a cohort of controlled hypertensive patients in Spain] // Med Clin (Barc). – 2011. – Vol. 136 (14). – P. 607-612 [Article in Spanish].
Sheppard J.P., Fletcher B., Gill P. et al. Predictors of the Home Clinic Blood Pressure Difference: A Systematic Review and Meta-Analysis Am J Hypertens. – 2016. – Vol. 29 (5). – P. 614-625. doi: 10.1093/ajh/hpv157.
Stergiou G.S., Asayama K., Thijs L. et al. on behalf of the International Database on Home blood pressure in relation to Cardiovascular Outcome (IDHOCO) Investigators Prognosis of White-Coat and Masked Hypertension International Database of Home Blood Pressure in Relation to Cardiovascular Outcome // Hypertension. – 2014. – Vol. 63. – P. 675-682.
Амосова К.М., Руденко Ю.В., Рокита О.І., Кацитадзе І.Ю. від імені групи дослідників. Ефективність уніфікованого покрокового алгоритму лікування для забезпечення контролю артеріального тиску у хворих з артеріальною гіпертензією в амбулаторній практиці: результати дослідження ПЕРФЕКТ // Серце і судини. – 2014. – № 1. – С. 34-46.
Parati G., Stergiou G.S., Asmar R., et al., ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring // J. Hypertens. – 2008. – Vol. 26. – P. 1505-1526.
Banegas J.R., Ruilope L.M., de la Sierra A. et al. High prevalence of masked uncontrolled hypertension in people with treated hypertension // European Heart Journal. – 2014. – Vol. 35. – P. 3304-12.
Kario K., Saito I., Kushiro T. et al. Effects of Olmesartan+Based Treatment on Masked, White-Coat, Poorly Controlled, and Well-Controlled Hypertension: HONEST Study // J Clin Hypertens (Greenwich). – 2014. – Vol. 16. – P. 442-450.
Andalib A., Akhtari S., Rigal R. et al. Determinants of masked hypertension in hypertensive patients treated in a primary care setting. Intern Med J. – 2012. – Vol. 42 (3). – P. 260-6.
Barochiner J., Cuffaro P.E., Aparicio L.S. et al. Predictors of masked hypertension among treated hypertensive patients: an interesting association with orthostatic hypertension // Am J Hypertens. – 2013. – Vol. 26 (7). – P. 872-8.
Asayama K., Thijs L., Brguljan-Hitij J. et al. Risk Stratification by Self-Measured Home Blood Pressure across Categories of Conventional Blood Pressure: A Participant-Level Meta-Analysis. PLoS Med. – 2014. – Vol. 11 (1): e1001591. doi: 10.1371/journal.pmed.1001591.
Mancia G. Should Guidelines «SPRINT» to lower blood pressure targets? – Positioning of the topic. https://esc365.escardio.org/presentation/131196#accessSession
Rosei E.A. Target Blood Pressure for Treatment Should Current Recommendations Be Changed? Hypertension. – 2016. – Vol. 68. – P. 263-265.
Weber M.A., Poulter N.R., Schutte A.E. et al. Is It Time to Reappraise Blood Pressure Thresholds and Targets? A Statement From the International Society of Hypertension – A Global Perspective // Hypertension. – 2016. – Vol. 68. – P. 266-268.
Амосова К.М., Руденко Ю.В. Медико-соціальне значення відсутності ефективного контролю артеріального тиску у хворих із неускладненою артеріальною гіпертензією в амбулаторній практиці // Серце і судини. – 2016. – № 1. – C. 53-63.
Wright J.T. Jr, Williamson J.D., Whelton P.K., et al; SPRINT Research Group. A Randomized trial of intensive versus standard blood pressure control // N Engl J Med. – 2015. – Vol. 373. – P. 2103-2116.
Thomopoulos C., Parati G, Zanchetti A. Effects of blood pressure lowering on outcome incidence in hypertension: 7. Effects of more vs. Less intensive blood pressure lowering and different achieved blood pressure levels – updated overview and meta-analyses of randomized trials // J Hypertens. – 2016. – Vol. 34. – P. 613-622.
