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Comparative effectiveness analysis of amlodipine/renin-angiotensin system blocker combinations

机译：氨氯地平/肾素-血管紧张素系统阻滞剂组合的比较疗效分析

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摘要

A comparative effectiveness analysis of antihypertensive therapy amlodipine (AML) and angiotensin receptor blocker (ARB) fixed- and loose-dose combinations (FDCs and LDCs) in achieving blood pressure (BP) reduction and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) goal attainment was made using retrospective electronic medical record (EMR) data. Treatment goal rates ranged from 35.0% for LDC AML/losartan to 45.7% for FDC AML/olmesartan (OM). FDC AML/OM achieved significantly greater reductions in systolic BP than FDC AML/benazepril (BEN), FDC AML/valsartan (VAL), and LDC AML/ARBs, respectively, and significantly greater reductions in diastolic BP than FDC AML/VAL and LDC therapy, respectively. Compared with patients treated with AML/OM, patients prescribed AML/VAL and LDC AML/ARB were significantly less likely to attain JNC 7 BP goal. Among subpopulations, AML/OM yielded higher rates of goal attainment among both African Americans and obese/overweight patients relative to AML/VAL and combined LDCs. Switchers from monotherapy with AML, OM, or VAL to AML/OM were significantly more likely to attain JNC 7 goals than those switching to AML/VAL or AML/BEN.
机译：降压治疗的氨氯地平（AML）和血管紧张素受体阻滞剂（ARB）固定剂量和散剂量组合（FDC和LDC）在降低血压（BP）方面的比较效果分析和全国预防，检测联合委员会第七次报告回顾性电子病历（EMR）数据确定，评估和评估高血压（JNC 7）的目标。治疗目标率从LDC AML /氯沙坦35.0％到FDC AML /奥美沙坦（OM）的45.7％不等。与FDC AML /贝那普利（BEN），FDC AML /缬沙坦（VAL）和LDC AML / ARB相比，FDC AML / OM的收缩压降低明显更大，与FDC AML / VAL和LDC相比，舒张压降低显着更大分别治疗。与接受AML / OM治疗的患者相比，处方AML / VAL和LDC AML / ARB的患者达到JNC 7 BP目标的可能性大大降低。在亚人群中，相对于AML / VAL和合并的最不发达国家，AML / OM在非洲裔美国人和肥胖/超重患者中产生更高的目标达成率。与采用AML / VAL或AML / BEN的患者相比，从采用AML，OM或VAL的单药治疗转为AML / OM的患者实现JNC 7目标的可能性更高。

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