Document Detail


Patterns of anti-hypertensive therapy in diabetic patients with and without reduced renal function.
MedLine Citation:
PMID:  20587868     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Renal function deterioration is a common complication in patients with diabetes mellitus and hypertension. Appropriate use of anti-hypertensive agents and tight control of blood pressure (BP) can minimize and delay such complications. This study was performed in order to investigate the utilization patterns of anti-hypertensive agents and to evaluate BP control among diabetic-hypertensive patients with and without reduced renal function. In a retrospective cohort study, all diabetic-hypertensive patients attending The Al-Watani Medical Governmental Center from August 01, 2006 until August 01, 2007 were enrolled in the study. Patients with congestive heart failure and/or end-stage renal disease were excluded from the study. The proportion of use of five different anti-hypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 drugs, and separately among patients with and without reduced renal function. Over 60% of patients were receiving angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blocker (ARB), followed by diuretics (40.8%), calcium channel blockers (25.1%) and (beta-blockers (12.5%). The majority of patients (> 55%) were either on mono or no drug therapy. Patients on monotherapy were mostly receiving ACEI/ARB (60%). In patients with reduced renal function, use of diuretics, but not ACEI/ARB or CCB, was higher and 41.8% of the patients were on monotherapy compared to 46.6% in patients with normal renal function. The proportion of patients achieving good BP control was 20% with mono-therapy and 28% with combination therapy. Our study suggests that the pattern of anti-hypertensive therapy was generally consistent with inter-national guidelines. Areas of improvement include increasing use of ACEI/ARB and diuretics, decreasing the number of untreated patients, and increasing the proportion of patients with well controlled BP in this population.
Authors:
Waleed M Sweileh; Ansam F Sawalha; Sa'ed H Zyoud; Samah W Al-Jabi; Eman J Tameem
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia     Volume:  21     ISSN:  1319-2442     ISO Abbreviation:  Saudi J Kidney Dis Transpl     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-30     Completed Date:  2010-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9436968     Medline TA:  Saudi J Kidney Dis Transpl     Country:  Saudi Arabia    
Other Details:
Languages:  eng     Pagination:  652-9     Citation Subset:  IM    
Affiliation:
College of Pharmacy, Clinical Pharmacy Graduate Program, Nablus, Palestine. waleedsweileh@najah.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antihypertensive Agents / standards,  therapeutic use*
Chi-Square Distribution
Diabetes Complications / drug therapy*
Diabetic Nephropathies / drug therapy*
Drug Therapy, Combination / statistics & numerical data
Female
Humans
Hypertension / drug therapy
Kidney Function Tests
Male
Middle Aged
Myocardial Ischemia / complications,  drug therapy
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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