Patterns of antihypertensive medication use in kidney transplant recipients.
OBJECTIVE
This study analyzed the prevalence of hypertension and the pattern of antihypertensive treatment before and after kidney transplantation.


METHODS
The prevalence of hypertension and the class and daily dosage load of antihypertensive medications were analyzed in 116 patients before kidney transplantation and 1, 6, and 12 months after transplantation (67.2 % males, mean age 45.9 ± 11.4 years). Two patients died and eight had the allograft explanted, leaving 106 patients in the final analysis. Blood pressure (BP) was recorded on the day of transplantation and at every follow-up; it was considered uncontrolled at values > 130/80 mmHg.


RESULTS
The prevalence of uncontrolled BP was significantly reduced after kidney transplantation (63.2 % before transplantation vs. 54.7, 41.5, and 25.5 % at the 1‑, 6‑, and 12-month follow-up, respectively, p < 0.001 for all). The number of prescribed antihypertensives did not change significantly during the follow-up (1.96 ± 1.03 before transplantation vs. 2.01 ± 0.88, 1.71 ± 0.78, and 1.73 ± 0.73 at the 1‑, 6‑, and 12-month follow-up, respectively, p > 0.05 for all). There was a significant decrease in antihypertensive drug load during the follow-up (1.08 ± 1.3 end of the study vs. 2.05 ± 2.32 before transplantation, p < 0.008). Before kidney transplantation, angiotensin-converting enzyme (ACE) inhibitors were most commonly prescribed (52.8 %), while after surgery β‑blockers gained prevalence (59.4-63.2 %). Mean arterial pressure decline correlated with an improvement of graft function.


CONCLUSIONS
The prevalence of uncontrolled BP and the antihypertensive drug dosage load reduced significantly after kidney transplantation. β‑blockers were used more frequently than ACE inhibitors after kidney transplantation.
Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 1, Belgrade, Serbia. ndivac@med.bg.ac.rs.
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Divac
Clinic of Nephrology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Pasterova 2, Belgrade, Serbia.
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Naumović
Clinic of Cardiology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovića 8, Belgrade, Serbia.
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Ristić
Clinic of Nephrology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Pasterova 2, Belgrade, Serbia.
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Milinković
Clinic of Nephrology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Pasterova 2, Belgrade, Serbia.
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Brković
Clinic of Nephrology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Pasterova 2, Belgrade, Serbia.
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Jovičić Pavlović
Clinic for Gynaecology and Obstetrics, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovića 26, Belgrade, Serbia.
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Glišić
Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 1, Belgrade, Serbia.
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Stojanović
Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 1, Belgrade, Serbia.
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Prostran
D000959:Antihypertensive Agents / Q000008:administration & dosage*; D015984:Causality; D015897:Comorbidity; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D015994:Incidence; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D020380:Needs Assessment; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000628:therapy*; D012307:Risk Factors; D055771:Serbia / Q000453:epidemiology; D016896:Treatment Outcome; D019564:Unnecessary Procedures / Q000706:statistics & numerical data
D000959:Antihypertensive Agents
Angiotensin-converting enzyme inhibitors; Antihypertensive agents; Beta-blockers; Hypertension; Kidney transplantation