Therapeutic response may be predicted by some clinical parameters in essential hypertensive patients.
Several clinical parameters have been studied in a sample of 211 essential hypertensives in order to determine their usefulness as predictors of therapeutic response. One hundred and twenty-four patients (58.8%) achieved normotension with monotherapy, whereas 87 hypertensives (41.2%) needed two or more drugs to control their BP values. Patients who required a combination of drugs exhibited higher levels of systolic and diastolic BP, higher frequency of acute severe hypertension before the beginning of treatment, a more advanced stage of hypertension, and higher plasma aldosterone levels when they were compared with those controlled with a single drug. Likewise, previous cardiovascular complications related to hypertension, enlargement of cardiac silhouette on chest x-ray films and left ventricular hypertrophy were more frequent in the former. By means of a logistic regression analysis, these last three parameters showed a significant relationship with the number of required drugs. We conclude that hypertensives exhibiting this clinical profile have a higher probability of requiring a combination of drugs in the pharmacological treatment of essential hypertension.
De la Sierra
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A
Department of General Internal Medicine, Hospital Clinico, School of Medicine, University of Barcelona, Spain.
Coca
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A
Sobrino
J
J
Lluch
M M
MM
Sánchez
M
M
Urbano-Márquez
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D006332:Cardiomegaly / Q000503:physiopathology; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis
D000959:Antihypertensive Agents; D000450:Aldosterone