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• W2022547089 abstract "Conocer el porcentaje de pacientes que estando sin controlar en monoterapia con betabloqueantes, inhibidores de la enzima conversora de la angiotensina o antagonistas del receptor de la angiotensina II alcanzan el control al añadir un segundo fármaco, concretamente un calcioantagonista (lercanidipino), estudiando si esto aumenta de forma significativa los efectos secundarios y su repercusión sobre la adherencia al tratamiento. Estudio multicéntrico, abierto, observacional, prospectivo y comparativo. Participan 100 médicos de Atención Primaria. Se incluyeron 884 hipertensos. De ellos, el 53,1 % mujeres; edad: 62,3 ± 9,7 años; con buena tolerabilidad a monoterapia, pero insuficiente control (sistólica: 140- 200 mmHg, y diastólica: 90-114 mmHg). Se administraron 10 mg/día de lercanidipino en asociación al fármaco previamente empleado en monoterapia durante un mes. Se analizó la respuesta de presión arterial considerando tanto los pacientes respondedores (reducción > 10 mmHg en presión arterial sistólica y > 5 mmHg en presión arterial diastólica) como los pacientes controlados (presión arterial < 140/90 mmHg). Tras un mes de tratamiento presentó presión arterial < 140 y 90 mmHg el 37,4 %. Fue respondedor el 91,1 %. La asociación de lercanidipino a betabloqueantes, inhibidores de la enzima conversora de la angiotensina o antagonistas del receptor de la angiotensina II consigue reducciones medias de sistólica de 18,1 mmHg y de 9,1 mmHg de diastólica. No encontramos diferencias en la magnitud de reducción de presión con ninguna de las combinaciones. El porcentaje de reacciones adversas fue del 3,4 % de intensidad leve- moderada, y en sólo el 0,3 % de los casos obligó a la retirada del tratamiento. El cumplimiento al final del estudio fue del 95,2 %. La asociación de un segundo fármaco antihipertensivo consigue control de la hipertensión arterial en el 37,4 % de los pacientes no controlados con monoterapia. La asociación de lercanidipino se muestra efectiva y muy bien tolerada con betabloqueantes, inhibidores de la enzima conversora de la angiotensina y antagonistas del receptor de la angiotensina II. Extrapolando los resultados de nuestro estudio tendríamos que, contabilizando los pacientes controlados en monoterapia según los resultados del estudio Controlpres y los que estando en monoterapia no controlados se controlarían añadiendo un segundo fármaco, el 66,8 % de la población hipertensa tratada presentaría cifras inferiores a 140/90 mmHg. To determine the percentage of hypertensive patients unable to be controlled monotherapeutically through the use of beta-blockers (ACEI or ARAII), but who are successfully controlled upon the addition of a second drug, namely a calcioantagonist (lercanidipine) to the treatment. The study is performed with a view toward any significant increases in side effects, as well as any repercussions for adherence to the treatment. An open, multicenter study which is observational, prospective and comparative. One hundred Primary Health Care physicians participated. There were included 884 hypertensive patients, 53.1% women; 62.3±9.7 years old; good tolerability to monotherapy but insufficient control (systolic: 140-200 mmHg; diastolic: 90-114 mmHg). 10 mg/day lercanidipine was administered for one month in association with that drug which had been being used monotherapeutically. >BP response was analyzed taking into consideration both responsive patients (reduction > 10 mmHg in SBP, and >5 mmHg in DBP) and controlled patients (BP<140/90 mmHg). After one month of treatment, 37.4 % of patients showed BP values of < 140/90 mmHg. 91.1% of patients were responsive. The combination of lercanidipine and betablockers, either ACEI or ARAII, obtained average reductions of 18.1 mmHg and 9.1 mmHg in SBP and DBP, respectively. No differences in reduction were observed from any one combination to another. There was a 3.4 % rate of adverse reaction (all light-to-moderate), and only 0.3 % of patients was obliged to withdraw from treatment. Compliance at the end of the study was 95.2 %. The addition of a second antihypertensive drug controls hypertension in 37.4 % of patients unable to be controlled monotherapeutically. Lercanidipine in combination with beta-blockers (either ACEI or ARAII) appears to be effective and well-tolerated. Taking into account the percentage of monotherapeutically-treated patients who are controlled (according to the Controlpres study) and those such non-controlled patients who could benefit from the addition of a second drug, our results could be extrapolated to assert that 66.8 % of the treated hypertensive population would present BP levels under 140/90 mmHg." @default.
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• W2022547089 title "Efecto de asociar una dihidropiridina a la monoterapia antihipertensiva" @default.
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• W2022547089 doi "https://doi.org/10.1016/s1889-1837(05)71522-1" @default.
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