title: Predicted coronary heart disease risk reduction and dual blood pressure/cholesterol goal attainment in patients with hypertension treated in real-world clinical practice.
abstract: Hypertension and dyslipidemia are highly co-prevalent, but often poorly controlled, coronary heart disease (CHD) risk factors. A retrospective cohort study was conducted between January 2004 and April 2008 to compare estimated 10-year CHD risk reduction and dual blood pressure and low-density lipoprotein cholesterol goal attainment (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel III]) in patients with a first prescription for amlodipine monotherapy, co-prescribed amlodipine + statin, or single-pill amlodipine/atorvastatin. In total, 2739 patients were prescribed amlodipine monotherapy, 653 were co-prescribed amlodipine + statin, and 227 were prescribed single-pill amlodipine/atorvastatin. Baseline CHD risk was similar in all 3 cohorts (11.0%-12.5%). Relative CHD risk reduction was greater in those prescribed single-pill amlodipine/atorvastatin (24.5%) compared with amlodipine monotherapy (14.4%, P<.01), and co-prescribed amlodipine + statin (18.4%, P=.01). The findings were driven by greater dual goal attainment for patients prescribed single-pill amlodipine/atorvastatin (50.2%) compared with amlodipine monotherapy (31.7%, P<.05) and co-prescribed amlodipine + statin (37.5%, P<.05).
authors.affiliation: Orange County Research Center, Tustin, CA 92780, USA. jmneutel@aol.com
authors.forename: Joel M
authors.initials: JM
authors.lastname: Neutel
authors.forename: Michael
authors.initials: M
authors.lastname: Eaddy
authors.forename: Orsolya E
authors.initials: OE
authors.lastname: Lunacsek
authors.forename: Craig
authors.initials: C
authors.lastname: Roberts
authors.forename: Linda
authors.initials: L
authors.lastname: Chen
authors.forename: Allison J
authors.initials: AJ
authors.lastname: Kean
authors.forename: James H
authors.initials: JH
authors.lastname: Jackson
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000069059:Atorvastatin; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D008078:Cholesterol, LDL; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000517:prevention & control*; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D055991:Health Records, Personal; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011758:Pyrroles / Q000627:therapeutic use; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D040242:Risk Reduction Behavior
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D017311:Amlodipine; D000069059:Atorvastatin