Abstract P024: Longer Acting Antihypertensives Improve Blood Pressure Control

Abstract

Introduction: Hypertension is a modifiable risk factor for cardiovascular and renal disease. It has been noted that blood pressure control has been decreasing over the past years throughout the US. In a quality improvement study, we are evaluating the effectiveness of longer acting antihypertensives in combination therapy with thiazide diuretic on blood pressure control in patients not sufficiently controlled. Methods: Participants included all clinic patients with diagnosed hypertension currently uncontrolled with BP >140/90. Their medications were modified to include a longer acting angiotensin II receptor blocker (ARB) and thiazide diuretic. Follow up visits were requested for 1 month and 3 months. Results: A total of 60 patients were started on longer acting ARB-thiazide therapy, of which 17 patients were included in analysis as follow up results were available. On follow-up visit, there was a mean decrease in blood pressure of 43.8 mmHg (95% CI 34.8 to 52.8, p <0.05) systolic and 18.9 mmHg (95% CI 11.9 to 25.9, p <0.05) diastolic. Of the 17 patients, 11 patients were switched from an ARB or an ARB-thiazide to a longer acting ARB-thiazide with a mean decrease in blood pressure of 41.0 mmHg (95% CI 30.5 to 51.5, p <0.05) systolic and 13.9 mmHg (95% CI 8.1 to 19.7, p <0.05) diastolic. Of the 11 patients, 7 were previously on an ARB-thiazide and switched to longer acting ARB-thiazide with a mean decrease in blood pressure of 33.5 mmHg (95% CI 24.7 to 46.2, p <0.05) systolic and 11.4 mmHg (95% CI 4.2 to 18.7, p <0.05). Conclusion: Including long-acting ARB and thiazide in antihypertensive regimen provided a statistically significant decrease in blood pressure.