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Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension
Although true treatment resistant hypertension is relatively rare (about 7.3% of all patients with hypertension), optimal control of blood pressure is not achieved in every other patient due to suboptimal treatment or nonadherence. The aim of this study was to compare effectiveness, safety and toler...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10238046/ https://www.ncbi.nlm.nih.gov/pubmed/37266607 http://dx.doi.org/10.1097/MD.0000000000033941 |
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author | Janković, Slobodan M. Stojković, Siniša Petrović, Milovan Kostić, Tomislav Zdravković, Marija Radovanović, Slavica Cvjetan, Radosava Ratković, Nenad Rihor, Branislav Spiroski, Dejan Stanković, Aleksandar Anđelković, Branko Gocić Petrović, Renata |
author_facet | Janković, Slobodan M. Stojković, Siniša Petrović, Milovan Kostić, Tomislav Zdravković, Marija Radovanović, Slavica Cvjetan, Radosava Ratković, Nenad Rihor, Branislav Spiroski, Dejan Stanković, Aleksandar Anđelković, Branko Gocić Petrović, Renata |
author_sort | Janković, Slobodan M. |
collection | PubMed |
description | Although true treatment resistant hypertension is relatively rare (about 7.3% of all patients with hypertension), optimal control of blood pressure is not achieved in every other patient due to suboptimal treatment or nonadherence. The aim of this study was to compare effectiveness, safety and tolerability of various add-on treatment options in adult patients with treatment resistant hypertension The study was designed as multi-center, prospective observational cohort study, which compared effectiveness and safety of various add-on treatment options in adult patients with treatment resistant hypertension. Both office and home blood pressure measures were recorded at baseline and then every month for 6 visits. The study cohort was composed of 515 patients (268 females and 247 males), with average age of 64.7 ± 10.8 years. The patients were switched from initial add-on therapy to more effective ones at each study visit. The blood pressure measured both at office and home below 140/90 mm Hg was achieved in 80% of patients with add-on spironolactone, while 88% of patients taking this drug also achieved decrease of systolic blood pressure for more than 10 mm Hg from baseline, and diastolic blood pressure for more than 5 mm Hg from baseline. Effectiveness of centrally acting antihypertensives as add-on therapy was inferior, achieving the study endpoints in <70% of patients. Adverse drug reactions were reported in 9 patients (1.7%), none of them serious. Incidence rate of hyperkalemia with spironolactone was 0.44%, and gynecomastia was found in 1 patient (0.22%). In conclusion, the most effective and safe add-on therapy of resistant hypertension were spironolactone alone and combination of spironolactone and a centrally acting antihypertensive drug. |
format | Online Article Text |
id | pubmed-10238046 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-102380462023-06-03 Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension Janković, Slobodan M. Stojković, Siniša Petrović, Milovan Kostić, Tomislav Zdravković, Marija Radovanović, Slavica Cvjetan, Radosava Ratković, Nenad Rihor, Branislav Spiroski, Dejan Stanković, Aleksandar Anđelković, Branko Gocić Petrović, Renata Medicine (Baltimore) 3400 Although true treatment resistant hypertension is relatively rare (about 7.3% of all patients with hypertension), optimal control of blood pressure is not achieved in every other patient due to suboptimal treatment or nonadherence. The aim of this study was to compare effectiveness, safety and tolerability of various add-on treatment options in adult patients with treatment resistant hypertension The study was designed as multi-center, prospective observational cohort study, which compared effectiveness and safety of various add-on treatment options in adult patients with treatment resistant hypertension. Both office and home blood pressure measures were recorded at baseline and then every month for 6 visits. The study cohort was composed of 515 patients (268 females and 247 males), with average age of 64.7 ± 10.8 years. The patients were switched from initial add-on therapy to more effective ones at each study visit. The blood pressure measured both at office and home below 140/90 mm Hg was achieved in 80% of patients with add-on spironolactone, while 88% of patients taking this drug also achieved decrease of systolic blood pressure for more than 10 mm Hg from baseline, and diastolic blood pressure for more than 5 mm Hg from baseline. Effectiveness of centrally acting antihypertensives as add-on therapy was inferior, achieving the study endpoints in <70% of patients. Adverse drug reactions were reported in 9 patients (1.7%), none of them serious. Incidence rate of hyperkalemia with spironolactone was 0.44%, and gynecomastia was found in 1 patient (0.22%). In conclusion, the most effective and safe add-on therapy of resistant hypertension were spironolactone alone and combination of spironolactone and a centrally acting antihypertensive drug. Lippincott Williams & Wilkins 2023-06-02 /pmc/articles/PMC10238046/ /pubmed/37266607 http://dx.doi.org/10.1097/MD.0000000000033941 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. |
spellingShingle | 3400 Janković, Slobodan M. Stojković, Siniša Petrović, Milovan Kostić, Tomislav Zdravković, Marija Radovanović, Slavica Cvjetan, Radosava Ratković, Nenad Rihor, Branislav Spiroski, Dejan Stanković, Aleksandar Anđelković, Branko Gocić Petrović, Renata Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension |
title | Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension |
title_full | Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension |
title_fullStr | Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension |
title_full_unstemmed | Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension |
title_short | Results of the trycort: Cohort study of add-on antihypertensives for treatment of resistant hypertension |
title_sort | results of the trycort: cohort study of add-on antihypertensives for treatment of resistant hypertension |
topic | 3400 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10238046/ https://www.ncbi.nlm.nih.gov/pubmed/37266607 http://dx.doi.org/10.1097/MD.0000000000033941 |
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