Hypertension outpatients’ therapy by angiotensin-converting enzyme inhibitors and angiotensin-II first type receptors blockers


DOI: https://dx.doi.org/10.18565/therapy.2020.3.69-75

Izmozherova N.V., Popov A.A., Bakhtin V.M.

Urals State Medical University of the Ministry of Healthcare of Russia, Ekaterinburg
The aim: the analysis of the clinical features and antihypertensive therapy efficacy in outpatients receiving angiotensin-converting enzyme inhibitors (ACEi) and angiotensin-II receptors blockers (ARB).
Material and methods. 135 hypertension outpatients at the therapists visit were included in one-moment study. The anamnesis was collected, anthropometry was carried out, blood pressure was measured and Charlson multimorbidity index was calculated in all patients. Sampling was divided into two groups: patients received ACEi (Group 1) and ARB (Group 2). Findings were performed as median and 25÷75% interval.
Results. Sampling of 135 outpatients included 99 (73,3%) women and 36 (26,7%) men. Age median was 68 (61÷76) years. 54 respondents (Group 1, 40,0%) received ACEi for the basis therapy and 63 received ARB (Group 2, 46,7%). There were not any anthropometric differences between Group 1 and 2. Concomitant disease detection rate did not differ between groups with the exception of stable angina pectoris and osteoarthritis that were more common in receiving ARB (p=0,028 and 0,002, respectively). Charlson multimorbidity index was 5 (3÷6) and did not differ between groups. Osteoarthritis presence was associated with ARB efficacy decreasing (p=0,034) but not ACEi (0,678). ACEi therapy was interrupted in 47,6% patients have ever received it, ARB was canceled in 25.9% received it (p=0,031). The most common withdrawal cause was side effects for ACEi and treatment failure for ARB.
Conclusion. The ARB prevalence over ACEi is Yekaterinburg outpatient clinical practice feature. Choice between ACEi and ARB remains empiric and it is determined by therapy tolerance and efficacy. Osteoarthritis and concomitant need in non-steroid anti-inflammatory drugs was associated with efficacy decrease both ACEi and ARB.
Keywords: angiotensin-II receptors blockers, multimorbidity, angiotensin-converting enzyme inhibitors, ACE inhibitors, arterial hypertension
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About the Autors

Nadezhda V. Izmozherova, MD, associate professor, head of the Department of pharmacology and clinical pharmacology of Urals State Medical University of the Ministry of Healthcare of Russia. Address: 620000, Ekaterinburg, 17 Klyuchevskaya Str. Tel.: +7 (343) 214-86-94. E-mail: Nadezhda_izm@mail.ru. ORCID: 0000-0001-7826-9657
Artem A. Popov, MD, associate professor, head of the Department of hospital therapy and emergency medical care of Urals State Medical University of the Ministry of Healthcare of Russia. Address: 620144, Ekaterinburg, 202a 8 Marta Str. Tel.: +7 (343) 240-60-39. E-mail: Art_popov@mail.ru. ORCID: 0000-0001-6216-2468
Victor M. Bakhtin, postgraduate student of the Department of pharmacology and clinical pharmacology of Urals State Medical University of the Ministry of Healthcare of Russia. Address: 620000, Ekaterinburg, 17 Klyuchevskaya Str.
Tel.: +7 (343) 214 86 94. E-mail: Bakhtin.v95@mail.ru. ORCID: 0000-0001-7907-2629


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