[Effectiveness of combined therapy at set doses in a cohort of hypertense patients not controlled by single therapy].
OBJECTIVE
To evaluate the effectiveness of the fixed dose of a lisinopril-hydrochlorothiazide combination treatment in the control of blood pressure, in poorly controlled high blood pressure people, treated with monotherapy.Design. Prospective observational study.Setting. Primary care frame.Participants. 931 patients (56.7% women) with an average age of 62.0+/-3 years, were included by 199 primary care physicians. 915 patients (98%) ended the study and finally they were included for the statistical analysis.


METHODS
OMS/SIH recommendations on blood pressure measurement and diagnose of poor control were followed. Pulse pressure, body mass index and basic clinical analyses were assessed. Four continuation visits were made during six months.


RESULTS
Lisinopril-hidrochlorothiazide (20/12.5 mg) reduced significantly SBP (24.6 +/- 3.5 mm Hg) and DBP (14,3 +/- 0.7 mm Hg) (P<.001). Blood pressure control was only influenced by age (OR, 0.81; 95% CI, 0.71-0.92; P=.001). Pulse pressure was reduced in 10.4 +/- 4.3 mm Hg (P<.001). After 24 weeks of treatment, glycemic and lipidic profiles showed an improvement, as well as HbA1c in diabetic people.


CONCLUSIONS
In Primary care, a 52.8% of poorly controlled with monotherapy high blood pressure people were controlled by a combination of lisinopril-hydrochlorothiazide (20/12.5 mg). In addition, pulse pressure was decreased and both lipid and glucose blood profiles improved.
Vegazo García
O
O
Departamento Médico. AstraZéneca Farmacéutica Spain, S.A. Madrid. España. onofre.vegazo@astrazeneca.com
Llisterri Caro
J L
JL
Jiménez Jiménez
F J
FJ
Aznar Vicente
J
J
Vicente Lozano
J
J
Estiarte Navarro
R
R
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D017706:Lisinopril / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D001786:Blood Glucose; D008055:Lipids; D006852:Hydrochlorothiazide; D017706:Lisinopril