Switching of antihypertensive drugs at tertiary care government hospital, Hyderabad, India: A cross-sectional retrospective investigation

Varakantham, Varsha; Sailoo, Ashok Kumar Kurakula; Venkaiah, K.; Bharatraj, Dinesh Kumar

doi:10.4103/ijp.ijp_590_17

Cited by 2 publications

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“…Our standard operational procedure for screening and confirmatory testing of PA comply with international recommendations to terminate interfering antihypertensive medications or to switch to medications with little influence on the aldosterone-to-renin ratio. In general, adjustment or switching of antihypertensive medication is known to cause side effects mainly due to uncontrolled blood pressure (21). Almost 20% of our patients reported side effects during the adjustment of antihypertensive medication phase that did not prompt the discontinuation of the non-interfering medications.…”

Section: Discussionmentioning

confidence: 80%

Safety of medical adjustment and confirmatory testing in the diagnostic work-up of primary aldosteronism

Heinrich

Adolf

Quinkler³

et al. 2019

European Journal of Endocrinology

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Objective Saline infusion test (SIT) and captopril challenge test (CCT) are standard confirmatory procedures routinely used in the diagnostic work-up of primary aldosteronism (PA). However, side effects and complications during testing have not been systematically studied. Design We performed a cohort study with patients undergoing SIT and/or CCT in two centers from 2016 until 2018. Methods We studied 272 study participants with suspected PA enrolled at two outpatient centers in Germany. We assessed the frequency and severity of side effects during adjustment of blood pressure medication and during SIT and CCT. Results During the adjustment phase prior confirmatory testing, side effects including palpitations, headaches, edema and hypertensive episodes occurred in 18.4% of study participants. Side effects were associated with higher defined daily doses (DDD) (r = 0.25, P < 0.005), number of antihypertensive drugs (r = 0.285, P < 0.005) and higher blood pressure (r = 0.145, P = 0.019). During SIT, 17.5% of study participants had side effects, associated with higher blood pressure (systolic: r = 0.541, P < 0.0005; diastolic: r = 0.426, P < 0.0005) and DDDs (r = 0.727, P < 0.0005). During CCT, only 1.5% of study participants developed side effects. Conclusions In contrast to the high rate of side effects during SIT, CCT appears to be the safer test with a very low event rate. This makes CCT especially suitable for severely hypertensive patients.

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Section: Discussionmentioning

confidence: 80%

Safety of medical adjustment and confirmatory testing in the diagnostic work-up of primary aldosteronism

Heinrich

Adolf

Quinkler³

et al. 2019

European Journal of Endocrinology

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Comparison of Efficacies of Commonly Used Hypertension Treatment Modalities: A Retrospective Study of 1900 Participants in a Hypertension Clinic

et al. 2020

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Background:Although various antihypertensive medications are available, some hypertensive patients have uncontrolled blood pressures, especially in the clinic. The aim of the present study was to compare the efficacies of various antihypertensive therapies in our hypertension (HTN) clinic (monotherapy vs. combination therapy, fixed-dose combination (FDC) versus free equivalent combination (FEC), and diuretics versus non-diuretics. Material/Methods:In this retrospective study, patients at the HTN clinic of the Third Xiangya Hospital with primary hypertension were enrolled from June 2016 to February 2017. Data on participants' basic characteristics, blood pressure data, and treatment modalities were collected. The proportions of participants attaining target blood pressure after treatment with antihypertensive modalities were calculated and compared. Results:Among 1900 participants, combination therapy had a better control efficacy than monotherapy (P<0.0005).When HTN was treated by 2 kinds of drugs, FEC was used much more frequently than FDC (P<0.0005). In grade 3 HTN, FDC had a higher control rate (P=0.002). If more than 2 kinds of drugs were used, FDC+OTHER had a slightly higher control rate in grade 2 and 3 (42.1% vs. 38.5%, P=0.724; 36.2% vs. 31.0%, P=0.526, respectively). Therapies with diuretics had better control rates than those without diuretics (43.1% vs. 36.9%, P=0.025). Conclusions:In our clinic, FEC was prescribed more often than FDC. When blood pressure is significantly elevated, especially at levels 2 or 3, FDC seems to have a better control rate than FEC. Therapies with diuretics controlled HTN more efficiently.

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Switching of antihypertensive drugs at tertiary care government hospital, Hyderabad, India: A cross-sectional retrospective investigation

Cited by 2 publications

References 20 publications

Safety of medical adjustment and confirmatory testing in the diagnostic work-up of primary aldosteronism

Safety of medical adjustment and confirmatory testing in the diagnostic work-up of primary aldosteronism

Comparison of Efficacies of Commonly Used Hypertension Treatment Modalities: A Retrospective Study of 1900 Participants in a Hypertension Clinic

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