[Antihypertensive drugs prescribed to patients before their first consultation in a hypertension uni
[Antihypertensive drugs prescribed to patients before their first consultation in a hypertension unit: Comparison between 2001 and 2006.]
PURPOSE: To determine if trends in antihypertensive drug prescriptions by non-specialist physicians reflect evidence from clinical research. METHODS: Comparison of antihypertensive drugs prescribed to patients before they attended a hypertension clinic in 2001 and 2006, with a special consideration for thiazide diuretics in drug combinations and angiotensin converting enzyme inhibitors (ACEI) in hypertensive patients at high cardiovascular risk (diabetes or secondary prevention). RESULTS: Overall, 1072 hypertensive patients attended the hypertension clinic in 2001 (mean age 53.9 years) and 1040 in 2006 (mean age 55.6 years); both genders were equally represented. Patients already treated when they came at the consultation received a mean number of 2.24 antihypertensive drug classes in 2001 and 2.44 in 2006 (p=0.002). The prescription of three antihypertensive drug classes increased between 2001 and 2006: Calcium channel blockers from 49 % of treated patients in 2001 to 56 % in 2006 (p=0.007), angiotensin receptor antagonists from 28 to 42 % (p<0.001) and thiazide diuretics from 31 to 39 % (p=0.001). Thiazide diuretics were included in 48 % of the antihypertensive combinations in 2001 and 55 % in 2006 (p=0.02). The prescription of ACEI in patients at high cardiovascular risk remained stable around 31 %. CONCLUSION: Antihypertensive treatments were more intensive in 2006 than 2001, but thiazide diuretics remained underused in drug combinations. The prescription of ACEI did not increase in patients at high cardiovascular risk despite convincing evidence of their benefit.
Steichen O, Plouin PF.
Inserm, U872, équipe 20/laboratoire de santé publique et informatique médicale, 15, rue de l’école de médecine, 75006 Paris, France; UMR S 872, université Pierre-et-Marie-Curie-Paris-6, 75006 Paris, France; UMR S 872, université Paris-Descartes, 75006 Paris, France; Service de médecine interne, hôpital Tenon, AP–HP, 4, rue de la Chine, 75020 Paris, France; Faculté de médecine, université Pierre-et-Marie-Curie-Paris-6, 75006 Paris, France.