The results of the pharmacoepidemiological study PIFAGOR IV concerning arterial hypertension (AH patients survey)

Abstract

Group of researchers analytical group of PIFAGOR IV study The aim is to study the next step of pharmacoepidemiology of arterial hypertension (AH) in Russia to evaluate the structure and frequency of different classes of antihypertensive drugs (AHD) usage in clinical practice.Material and methods. The prospective pharmacoepidemiological multicenter study (PIFAGOR IV). We interrogated AH patients using special prepared questionnaires. The collection of questionnaires took place from February to July, 2013. The study included 2533 valid questionnaires from 52 cities and towns of Russia.Results. 80% of the patients regularly take AHD; 32.8% of patients receive monotherapy, 38.6% receive two AHD combinations, 28.4% - 3 or more AHD combinations. The average number of AHD was 2.02 per patient. The structure of AHD consisted of 5 recommended classes: ACE inhibitors (27.8%), -adrenergic receptor blocking agents (21.7%), diuretics (15.7%), calcium antagonists (11.3%) and angiotensin II receptor blockers (10.7%), fixed combination - 10.8%. Additional proportion of classes: central-acting agents - 2.3% and b-adrenoceptor blocking agents - 0.1%. Among the ACE inhibitors the main share had 3 drugs: enalapril (33.6%), perindopril (16%), and lisinopril (13%). In b-blockers class the main share had 2 drugs - bisoprolol (64.4%), and usual form of release and modified release dosage form of metoprolol (the total share 21,4%). Indapamide of standard and retard form took the first place in the structure of diuretics (the total share 75%). In calcium antagonists class the main share had amlodipine (55.8%). The main drug in ARBs II was losartan (55.4%). Central-acting agent class was consisted of moxonidine (66%), methyldopa (17%) and clonidine (5%). For about 76% of cases were presented by combinations containing diuretics and 24% - by combinations containing calcium antagonists among the fixed combinations. The proportion of original drugs in the structure of AHD was 38.3%. The average BP level in patients was 140.4/86.4 mm Hg and the blood pressure targets were determined in 50.2% of cases. A high degree of compliance according to the Morisky-Green test indicated in 32%, low compliance - in 49% of cases.Conclusions. We noted the reduction of ACE inhibitors proportion and increase of ARBs II proportion, increase of fixed combinations in the structure of AHD. However, we noticed the decrease of the treatment efficacy in patients with AH using average BP level and achievement of the target BP, as well as the average number of AHD.

Keywords

• pharmacoepidemiology
• arterial hypertension
• antihypertensive agents
• compliance