Preview

Russian Journal of Cardiology

Advanced search

RESULTS OF PHARMACOEPIDEMIOLOGIC STUDY OF ARTERIAL HYPERTENSION PIFAGOR IV: PHYSICIANS COMPLIANCE

https://doi.org/10.15829/1560-4071-2015-1-59-66

Abstract

Aim. To conduct the new stage of pharmaco-epidemiologic study of AH — PIFAGOR
IV to study the structure and prevalence of various classes of antihypertensive drugs
usage (ADU) in clinical practice. Material and methods. The study was conducted with physicians questionnaires usage
(GPs, cardiologists), having the practice of AH patients treatment with specially developed questionnaires. Totally 1105 physicians studied (67,5% GPs, 28,1% cardiologists, 8,2% the others) from 73 cities and other places during the period from february to july 2013. Results. The ADU structure by physicians in AH patients includes 5 main recommended drug classes: ACE inhibitors (24,2%), b-adrenoblockers (18,9%), diuretics (18,9%), calcium channel antagonists (17,4%) and angiotensin II receptor blockers (16%), totally 95,4%. Other classes included: central-acting drugs — 3,4%, a-adrenoblockers — 1,2%. In ACE inhibitors class the main are five following: perindopril (20,3%), enalapril (18,3%), lisinopril (18,5%), ramipril (14,2%) and fosinopril (13,6%). In b-blocker class the main are bisoprolol (30,2%), metoprolol in modified and common compounds (25,2%), carvedilol (16%). Diuretic class consists by a half of indapamide (54,8%), torasemide (18,4%), hydrochlorothiazide (19,4%). In calicum antagonists the main are amlodipine (32,6%) including S-amlodipine (1,8%), nifedipine in various forms (21,5%), with modified release — 14,3%, verapamil in various forms (14,6%), diltiazem (13%). In ARBII the main are losartan (37,3%), valsartan (29,9%). Central drug class included moxonidine (74,1%), rilmenidine (8%), clopheline (18%). The part of physicians compliant to fixed drug combinations increased to 52,6%; the part of ACE inhibitors with calcium channel blockers increased to 29,1%, and decrease found for b-blockers with diuretic — 15,6%. Physicians use more adequate criteria for AHT and recommended criteria for treatment effectiveness control (target BP).Conclusion. Analysis of physicians compliance showed the relevance to national guidelines for diagnostics and treatment of AH; physicians actively use combination therapy and modern fixed dose compounds.

About the Authors

M. V. Leonova
SBEI HPE Russian National Research Medical University n. a. N. I. Pirogov, Moscow
Russian Federation


L. L. Steinberg
SBEI HPE Russian National Research Medical University n. a. N. I. Pirogov, Moscow
Russian Federation


Yu. B. Belousov
SBEI HPE Russian National Research Medical University n. a. N. I. Pirogov, Moscow
Russian Federation


D. V. Belyavskaya
SBEI HPE Russian National Research Medical University n. a. N. I. Pirogov, Moscow
Russian Federation


O. I. Vydrina
SBEI HPE Russian National Research Medical University n. a. N. I. Pirogov, Moscow
Russian Federation


E. Yu. Pasternak
SBEI HPE Russian National Research Medical University n. a. N. I. Pirogov, Moscow
Russian Federation


D. Yu. Belousov
Russian Society of Clinical Investigators, Moscow, Russia
Russian Federation


References

1. Mancia G, De Backer G, Dominiczak A, et al. 2007 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). J Hypertens 2007; 25:1105-87.

2. Mancia G, Laurent S, Agabiti–Rosei E, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertension 2009; 27: 2121-58.

3. Mancia G, Fagard R, 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). J Hypertension 2013; 31: 1281-357.

4. Russian Medical Society of hypertension (RMOAG), Russian Scientific Society of Cardiology (GFCF). Diagnosis and treatment of arterial hypertension. Russian recommendations (fourth revision), 2010. (Российское медицинское общество по артериальной гипертонии (РМОАГ), Всероссийское научное общество кардиологов (ВНОК). Диагностика и лечение артериальной гипертензии. Российские рекомендации (четвертый пересмотр), 2010).

5. Leonova MV, Belousov DY, analytical research group PIFAGOR. The first Russian pharmacoepidemiological study of hypertension. Good Clinical Practice, 2002; 3: 47-53. (Леонова М. В., Белоусов Д. Ю., аналитическая группа исследования ПИФАГОР. Первое Российское фармакоэпидемиологическое исследование артериальной гипертонии. Качественная клиническая практика, 2002; 3: 47-53).

6. Leonova MV, Belousov DY, Steinberg LL, analytical research group PIFAGOR. Analysis of the medical practice of antihypertensive therapy in Russia (according to a study PIFAGOR III). Farmateka, 2009; 12: 98-103. (Леонова М. В., Белоусов Д. Ю., Штейнберг Л. Л. аналитическая группа исследования ПИФАГОР. Анализ врачебной практики проведения антигипертензивной терапии в России (по данным исследования ПИФАГОР III). Фарматека 2009; 12: 98–103).

7. Elliott W, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007; 369: 201-7.

8. Lindholm LH, Carlberg B, Samuelsson O. Should b-blockers remain the first choice in the treatment of primary hypertension? Lancet 2005; 366: 1545-53.

9. Leonetti G. Clinical positionning of indapamide sustained release 1,5 mg in management protocols for hypertension. Drugs 2000; 59 (suppl. 2): 27-38.

10. Roca-Cusachs A, Aracil-Vilar J, Calvo-Go´mez C, et al. Clinical effects of torasemide prolonged release in mild-to-moderate hypertension: a randomized noninferiority trial versus torasemide immediate release. Cardiovascular Therapeutics 2008; 26(2): 91-100.

11. Lee S-A, Choi H-M, Park H-J, et al. Amlodipine and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus other antihypertensive therapy. Korean J Intern Med. 2014; 29: 315-24.

12. Wang JG, Li Y, Franklin SS, et al. Prevention of stroke and myocardial infarction by amlodipine and angiotensin receptor blockers. A quantitative overview. Hypertension. 2007; 50: 181-8.

13. Liu F, Qiu M, Zhai SD. Tolerability and effectiveness of (S)-amlodipine compared with racemic amlodipine in hypertension: a systematic review and meta-analysis. Curr Ther Res Clin Exp. 2010; 71(1): 1-29.

14. Smith TR, Philipp T, Vaisse D , et al. Amlodipine and valsartan combined and as monotherapy in stage 2 elderly and black hypertensive patients: subgroup analyses of 2 randomized, placebo-controlled studies. J Clin Hypertens. 2007; 9: 335–64.


Review

For citations:


Leonova M.V., Steinberg L.L., Belousov Yu.B., Belyavskaya D.V., Vydrina O.I., Pasternak E.Yu., Belousov D.Yu. RESULTS OF PHARMACOEPIDEMIOLOGIC STUDY OF ARTERIAL HYPERTENSION PIFAGOR IV: PHYSICIANS COMPLIANCE. Russian Journal of Cardiology. 2015;(1):59-66. (In Russ.) https://doi.org/10.15829/1560-4071-2015-1-59-66

Views: 1881


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)