Polypharmacy in the Treatment of Arterial Hypertension and Heart Failure

Abstract

Due to the development of the pharmaceutical industry, today there are a large number of drugs with similar properties and efficacy, but little-studied pharmacodynamics and pharmacokinetics. There fore many medicines are prescribed more often and in larger quantities than necessary. That is why patients and doctors often face the problem of polypharmacy in various fields of medicine including cardiology. The paper presents the results of the analysis of 249 case histories of inpatients with cardiac profile. All patients with underlying cardiac pathology (arterial hypertension, ischemic heart disease) had concomitant diseases. Patients with arterial hypertension had other concomitant diseases, most often gout, diseases of the digestive system, anemia. Chronic heart failure was found in the majority of patients with arterial hypertension, ischemic heart disease, chronic rheumatic heart disease. We have determined which pharmacological groups of drugs are prescribed to patients with arterial hypertension or chronic heart failure and concomitant diseases: more than 60 % of patients are prescribed drugs that are unsuitable for their condition. We analyzed and compared treatment standards in Ukraine and the world and carried out that doctors in Ukraine use modern and effective methods of treatment. The risks of prescribing a large number of drugs to patients are analyzed and the risks of dangerous drug interactions that can threaten the life or health of the patient are identified. In particular, in the treatment of cardiac patients, doctors used combinations of calcium antagonists and beta-blockers, NSAIDs and antithrombotic drugs, corticosteroids and antibacterial drugs of the fluoroquinolone group, ACE inhibitors and potassium-preserving diuretics, antiarrhythmic drugs and highly active diuretics, etc. We compared medicinal prescriptions for the treatment of cardiovascular diseases with an interval of 10 years and revealed that in 2008 the therapy often did not comply with the international and Ukrainian treatment protocols, however, in 2018, unwanted drug interactions were found 4 times less often. That reflects the trend of doctors’ awareness of pharmacology and evidence-based medicine.