1. Management of Hypertensive Patients With Multiple Drug Intolerances: A Single-Center Experience of a Novel Treatment Algorithm.
- Author
-
Antoniou, Sotiris, Saxena, Manish, Hamedi, Nadya, Cates, Catherine, Moghul, Sakib, Lidder, Satnam, Kapil, Vikas, Lobo, Melvin D., and de Cates, Catherine
- Subjects
HYPERTENSION & psychology ,ALGORITHMS ,AMBULATORY blood pressure monitoring ,BLOOD pressure ,COMBINATION drug therapy ,COMPARATIVE studies ,DRUG monitoring ,DRUG resistance ,DRUGS ,ANTIHYPERTENSIVE agents ,HYPERTENSION ,RESEARCH methodology ,EVALUATION of medical care ,MEDICAL cooperation ,PATIENT compliance ,RESEARCH ,EVALUATION research ,RETROSPECTIVE studies ,PSYCHOLOGY ,DIAGNOSIS - Abstract
Multiple drug intolerance to antihypertensive medications (MDI-HTN) is an overlooked cause of nonadherence. In this study, 55 patients with MDI-HTN were managed with a novel treatment algorithm utilizing sequentially initiated monotherapies or combinations of maximally tolerated doses of fractional tablet doses, liquid formulations, transdermal preparations, and off-label tablet medications. A total of 10% of referred patients had MDI-HTN, resulting in insufficient pharmacotherapy and baseline office blood pressure (OBP) of 178±24/94±15 mm Hg. At baseline, patients were intolerant to 7.6±3.6 antihypertensives; they were receiving 1.4±1.1 medications. After 6 months on the novel MDI-HTN treatment algorithm, both OBP and home blood pressure (HBP) were significantly reduced, with patients receiving 2.0±1.2 medications. At 12 months, OBP was reduced from baseline by 17±5/9±3 mm Hg (P<.01, P<.05) and HBP was reduced by 11±5/12±3 mm Hg (P<.01 for both) while patients were receiving 1.9±1.1 medications. Application of a stratified medicine approach allowed patients to tolerate increased numbers of medications and achieved significant long-term lowering of blood pressure. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF