고혈압 환자 대상 Amlodipine, Olmesartan, Hydrochlorothiazide 복합제의 유효성 및 안전성 평가
Efficacy and Safety of a Combination of Amlodipine, Olmesartan, and Hydrochlorothiazide at Fixed Dose in Hypertension
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Background : A combination therapy is recommended for hypertension in order to increase the therapeutic effect. Fixed dose combinations (FDCs) can improve medication compliance, thus enhancing the therapeutic effect of medications. However, there are some limitations in selecting the components and dose level of medications. The objective of this study was to determine the efficacy and safety of FDC of amlodipine, olmesartan, hydrochlorothiazide (HCTZ) in patients who are taking more than three hypertensive medications. Methods : We reviewed the electronic medical record data of hypertension patients who have taken calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs), and HCTZ over 6 months and changed antihypertensive treatment to FDC between December 1st, 2014 and March 31st, 2015. Patients have taken CCBs, ARBs, HCTZ as single agents or dual agents plus single agent. For subanalysis, patients who have taken the same component FDC before changing to FDC are assigned to group 1. Patients who have taken different components but in the same classes of FDC are assigned to group 2. The primary outcome is the proportion of patients who achieved target blood pressure (BP) before and after switching to FDC. Results : A total of 135 patients were included in this study, including 48 patients in group 1 and 87 patients in group 2. The proportion of patients who achieved target BP (< 140/90 mmHg) was increased (p = 0.105) from 64.4% to 73.3% after switching to FDC. In group 1, the proportion of patients who achieved target BP was increased (p = 0.258) from 75.0% to 83.3%. In group 2, it was increased (p = 0.157) from 58.6% to 67.8%. Approximately 8.2% of patients experienced adverse drug reactions with dizziness was the most common adverse event. Conclusions : There was no significant difference in proportion of patients who achieved target BP before and after being treated with FDC, even in patients who have taken different components but in the same class of FDC. Despite our limitations in selecting components and dosage range, FDC can be used to improve medication compliance and persistency.
Abstract
Background : A combination therapy is recommended for hypertension in order to increase the therapeutic effect. Fixed dose combinations (FDCs) can improve medication compliance, thus enhancing the therapeutic effect of medications. However, there are some limitations in selecting the components and dose level of medications. The objective of this study was to determine the efficacy and safety of FDC of amlodipine, olmesartan, hydrochlorothiazide (HCTZ) in patients who are taking more than three hypertensive medications. Methods : We reviewed the electronic medical record data of hypertension patients who have taken calcium channel blockers (CCBs), angiotensin receptor blockers (ARBs), and HCTZ over 6 months and changed antihypertensive treatment to FDC between December 1st, 2014 and March 31st, 2015. Patients have taken CCBs, ARBs, HCTZ as single agents or dual agents plus single agent. For subanalysis, patients who have taken the same component FDC before changing to FDC are assigned to group 1. Patients who have taken different components but in the same classes of FDC are assigned to group 2. The primary outcome is the proportion of patients who achieved target blood pressure (BP) before and after switching to FDC. Results : A total of 135 patients were included in this study, including 48 patients in group 1 and 87 patients in group 2. The proportion of patients who achieved target BP (< 140/90 mmHg) was increased (p = 0.105) from 64.4% to 73.3% after switching to FDC. In group 1, the proportion of patients who achieved target BP was increased (p = 0.258) from 75.0% to 83.3%. In group 2, it was increased (p = 0.157) from 58.6% to 67.8%. Approximately 8.2% of patients experienced adverse drug reactions with dizziness was the most common adverse event. Conclusions : There was no significant difference in proportion of patients who achieved target BP before and after being treated with FDC, even in patients who have taken different components but in the same class of FDC. Despite our limitations in selecting components and dosage range, FDC can be used to improve medication compliance and persistency.
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