Therapeutic concordance improves blood pressure control in patients with resistant hypertension.
Therapeutic concordance improves blood pressure control in patients with resistant hypertension.
复制标题
治疗一致性可改善难治性高血压患者的血压控制。
DOI：
10.1016/j.phrs.2022.106557
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发表时间：
2023-01
影响因子：
9.3
通讯作者：
Trimarco B
中科院分区：
文献类型：
--
作者：
Trimarco V;Izzo R;Mone P;Lembo M;Manzi MV;Pacella D;Falco A;Gallo P;Esposito G;Morisco C;Santulli G;Trimarco B
移情方法可能对治疗难治性高血压（TRH）患者特别有用，TRH定义为尽管最大剂量的3种降压药物（包括利尿剂）仍未能达到目标血压（BP）。然而，治疗一致性对高血压患者的影响尚未确定。我们设计了一项研究，以探讨TRH患者的治疗一致性的影响，这些患者被纳入基于方案的干预组，其中受过培训的人员定期验证这些患者的药理学方案。在对5331例高血压患者随访77.64 ± 34.44个月的队列中，发现886例受试者有TRH;其中322例有明显的TRH（aTRH：未控制的办公室血压，但最佳家庭血压），285例拒绝参加第二次随访研究，产生279例真正的TRH（tTRH）患者。根据治疗一致性方案，对这些tTRH患者进行了91.91 ± 54.7个月的随访，结果显示，210例患者（75.27%）的血压仍不受控制（不受控制的tTRH，组I），而69例患者（24.73%）的血压达到最佳控制（至少50%的随访访视中平均血压<140/90 mmHg，组II）。值得注意的是，在第二次随访结束时，II组中显示肾功能下降的患者百分比显著低于I组（8.5% vs 23.4%，p < 0.012）。总之，我们的研究结果首次表明，治疗一致性显着改善了TRH患者人群的抗高血压治疗的结果。
An empathetic approach may be particularly useful in patients with therapy-resistant hypertension (TRH), defined as the failure to achieve target blood pressure (BP) despite a maximal doses of 3 antihypertensive drugs including a diuretic. However, the effects of therapeutic concordance have not been determined in hypertensive patients. We designed a study to explore the impact of therapeutic concordance in patients with TRH, who were included in an intervention arm based on a protocol in which trained personnel periodically verified the pharmacological regimen of these patients. From a cohort of 5331 hypertensive patients followed-up for 77.64 ± 34.44 months, 886 subjects were found to have TRH; of these, 322 had apparent TRH (aTRH: uncontrolled office BP but optimal home BP) and 285 refused to participate in a second follow-up study, yielding a population of 279 patients with true TRH (tTRH). These tTRH patients were followed according to the therapeutic concordance protocol for 91.91 ± 54.7 months, revealing that 210 patients (75.27%) remained with uncontrolled BP (uncontrolled tTRH, Group I) while 69 patients (24.73%) reached an optimal BP control (average BP <140/90 mmHg in at least 50% of follow-up visits, Group II). Strikingly, at the end of the second follow-up, the percentage of patients displaying a decline in kidney function was significantly smaller in Group II than in Group I (8.5% vs 23.4%, p < 0.012). Taken together, our findings indicate for the first time that therapeutic concordance significantly improves the outcome of antihypertensive treatment in a population of patients with TRH.
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影响因子：
3.2
作者：
Canciello, Grazia;Mancusi, Costantino;De Luca, Nicola
通讯作者：
De Luca, Nicola
影响因子：
2.7
作者：
Banerjee A;Sanyal D
通讯作者：
Sanyal D
DOI：
10.2215/cjn.11511114
发表时间：
2015-06-01
影响因子：
9.8
作者：
Heerspink, Hiddo J. Lambers;Gansevoort, Ron T.
通讯作者：
Gansevoort, Ron T.
影响因子：
16.2
作者：
Anderson, Robert J.;Bahn, Gideon D.;Duckworth, William C.
通讯作者：
Duckworth, William C.
影响因子：
3.2
作者：
Casalnuovo, Giuseppina;Gerdts, Eva;De Luca, Nicola
通讯作者：
De Luca, Nicola