ANTIHYPERTENSIVE THERAPY INTAKE IN THE PURE COLOMBIA COHORT 2005-2021

Abstract

Objective: Describe changes in antihypertensive therapy in prevalent hypertension (HT) cases in the PURE cohort (The Prospective Urban Rural Epidemiology) Colombia in 2005-2021. Design and method: A prospective cohort study including 7552 participants from the baseline PURE Colombia cohort from 11 departments (Atlántico, Bolívar, Caldas, Casanare, Cauca, Cesar, Cundinamarca, Nariño, Quindío, Santander, Tolima). We conducted a descriptive analysis of the change in antihypertensive therapy between the 2005 baseline and the cut-off point to 2021. Results: At baseline, 2846 (37.7%) hypertensive participants were identified, 65.7% of which were women, with a mean age of 55.2 (SD 9.2) years. After 13 years of follow-up, 902 incident cases of HT were reported, 67.2% of which were women, increasing the prevalence within the cohort to 50.2% Regarding the prevalences of antihypertensive drug use, in 2005 vs 2021 the observed changes were: angiotensin-converting enzyme inhibitors (ACEI) 23.7% vs 9.2%, thiazide diuretics (TD) 10.1% vs 6.0%, angiotensin receptor antagonists (ARBs) 4.5% vs 28.8% and lastly, dihydropyridine calcium channel blockers (DCCB) 4.0% vs 5.2%. The differences in the use of antihypertensive drugs between baseline and follow-up were significant, 55.7% of the patients reported no use of antihypertensive drugs at baseline vs 59.8% at follow-up, 20.0% were on monotherapy and the proportion dropped to 18.9%, 24.3% reported use of 2 or more drugs at baseline and 21.3% at follow-up. Conclusions: The significant increase in hypertension suggests the need to adopt recommendations for drug consumption that have abandoned the use of monotherapy; however, the changes in the management of hypertensive patients in the cohort show no improvement. There is a need to undertake strategies that encourage access to fixed-dose combination antihypertensive therapy.