[PP.32.10] A COMPARATIVE ANALYSIS OF THE HYPERTENSION TREATMENT DEPENDING ON COMORBIDITIES: INSIGHTS FROM CLINICAL PRACTICE

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Abstract

Objective:

The presence of comorbidities influences the drug treatment of arterial hypertension. The objective of the study was to investigate the antihypertensive treatment according to associated comorbidities in hospitalized hypertensive patients.

Design and method:

The study included 200 patients with arterial hypertension consecutively hospitalized in the Internal Medicine Clinic of a University Emergency Hospital, in 2015. We retrospectively analyzed data from the hospital record database, using Analyse-IT software.

Results:

The mean age of the patients was 66 ± 12.2 years old. The distribution of main comorbidities in the group of study: dyslipidemia 56%, diastolic dysfunction 54.7%, left ventricle hypertrophy 52%, heart failure 42%, obesity 29.8%, type 2 diabetes 28%, chronic kidney disease 16.2%, carotid atheromatosis 12.7%, atrial fibrillation 11.2%, peripheral arterial disease 3.6%, hyperuricemia 1.2%. We did not find a significant difference regarding the class of antihypertensive drugs in patients with or without coronary heart disease, heart failure, chronic kidney disease, dyslipidemia, sleep apnea syndrome. More hypertensive patients with diabetes compared with nondiabetics were treated with ACE inhibitors (85% versus 59%, p = 0.001); 13.3% of diabetics were treated with ARBs, compared with 30.8% of non-diabetics (p = 0.02). We did not find any difference regarding the calcium antagonists, diuretics, central antihypertensives between diabetics and non-diabetics. 58.7% of patients with left ventricle hypertrophy were treated with diuretics, compared with 41% of patients without left ventricle hypertrophy (p = 0.052). 77% of obese patients were treated with ACE inhibitors, versus 61% of nonobese (p = 0.07).

Conclusions:

Diabetic hypertensive patients are more likely to receive ACE inhibitors than nondiabetics; nondiabetics hypertensive patients receive more ARBs. Similarly, obese hypertensive patients are more likely to receive ACE inhibitors than nonobese ones.

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