[Assessment of antihypertensive monotherapies effectiveness by home blood pressure self-measurement in hypertensive patients].
OBJECTIVE
To evaluate the blood pressure (BP) control and the efficacy of antihypertensive monotherapy using home BP self-measurement in a French population of treated hypertensive subjects in 2007 2009 and 2010.


METHODS
The French League Against Hypertension Surveys (FLAHS) are conducted among a representative sample of individuals aged 35 years and older living in France. For the 2007, 2009 and 2010 surveys, a sample of 1467 subjects who owned a BP self-measurement device and performed three consecutive morning BP measurements were included. Among the 60% of subjects who reported taking at least one antihypertensive drug, we analyzed subjects treated with one of the following antihypertensive monotherapy, i.e., beta-blocker (BB), ACE inhibitors, calcium channel blocker (CCB) and angiotensin receptor blockers (ARB).


RESULTS
Among treated hypertensive subjects (n=886), 66% (n=586) had home BP below the 140/90mmHg threshold and 50% (n=449) below 135/85mmHg. Three hundred two subjects were treated with a single antihypertensive drug, 33% had ARB, 25% BB, 19% CCB and 13% ACE inhibitors. Age (years) for each treatment group is different (P<0.01) CCB (72.1±9.3), BB (65.6±9.8), ARB (68.6±8.9) and ACEI (67.3±10.2). The mean systolic/diastolic BP (mmHg) is not comparable between monotherapy 130.7/76.1 (ARB), 130.7/78.7 (BB), 134.0/75.2 (CCB) and 139.1/80.3 (ACEI) for ARB, BB, CCB and ACE inhibitors respectively. Compared to ACE inhibitors, BP was significantly lower with ARB (P<0.01). The proportion of subjects with a BP below 140/90mmHg was 73% for ARB, 52% for BB, 68% for CCB and 47% for ACE with a statistical significance (P=0.03) for ARB vs. ACEI and CCB vs. ACEI.


CONCLUSIONS
Among subjects treated for hypertension who owned a BP self-measurement device, 50 to 66% had a controlled BP (depending on the threshold used). It is observed differences between antihypertensive efficacy of monotherapy with a larger number of patients controlled with ARB or CCB.
Comité français de lutte contre l'hypertension artérielle (CFLHTA), 5, rue des Colonnes-du-Trône, 75012 Paris, France. olivier.hanon@brc.aphp.fr
O
O
Hanon
P
P
Laroche
J-S
JS
Vidal
B
B
Pannier
N
N
Postel-Vinay
B
B
Vaisse
X
X
Girerd
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000465:Algorithms; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D005260:Female; D005602:France / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers