Naslov
Telmisartan in daily clinical practice : Factors affecting efficacy in treatment of primary arterial hypertension

Autori
Bergovec, Mijo ; Knežević, Aleksandar ; Plavec, Davor ; Trkulja, Vladimir

Izvornik
Journal of postgraduate medicine (0022-3859) 55 (2009), 1; 27-32

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Daily practice ; essential hypertension ; predictors ; telmisartan

Sažetak
Telmisartan provides effective treatment of hypertension in a broad spectrum of patients. Aims were to evaluate factors affecting the efficacy of telmisartan in daily clinical practice. Prospective practice-based 12-week uncontrolled cohort study. Consecutive incident/prevalent outpatients with mild to moderate essential hypertension were started on telmisartan 40 mg/day with optional up- titration to 80 mg/day in order to achieve seated systolic (SSBP) and diastolic (SDBP) blood pressure <140/90 mm Hg. Intent-to-treat (ITT, N=282) and per protocol (PP, N=275) efficacy assessment was based on SSBP/SDBP reduction and delivered doses. SSBP/SDBP decreased (165.2±13.1 / 98.3±6.7 mm Hg to 137.9±13.2 / 82.6±7.3 mm Hg), whilst telmisartan was up-titrated in 40.5% of patients during the study. Multivariate (practically identical ITT and PP) analysis indicated poorer response in obese vs. non- obese patients: lesser SDBP reduction (by around 2.2-2.3 mm Hg, P <0.05) with higher odds of dose up-titration (odds ratio, OR around 1.90, P <0.05) ; and better response in: a) patients started on telmisartan monotherapy than when added to a preexisting treatment: greater SSBP/SDBP reduction (by around 4.0 and 3.0 mm Hg, respectively, P <0.05) with comparable odds of up-titration ; b) diabetics vs. non-diabetics: greater SDBP reduction (by around 3.6-3.7 mm Hg, P <0.05) with comparable odds of up-titration ; c) men vs. women: slightly greater SDBP reduction (by around 1.2 mm Hg, 0.05< P <0.1) with lower odds of up- titration (OR around 0.51, P <0.05). Previous unsuccessful treatment, obesity, diabetes and gender should be considered in order to optimize the use of telmisartan for mild to moderate essential hypertension in daily clinical practice.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA