Transcript the slide set

Initial monotherapy and
combination therapy and
hypertension control the
first year
Egan BM, Bandyopadhyay D, Shaftman SR, Wagner CS, Zhao Y,
Yu-Isenberg KS. Hypertension. 2012;59:1124-1131.
Patient characteristics
 180 Clinical sites – 106 621 patients
 Patients included were untreated and
uncontrolled for ≥6 months before initial
therapy, and had ≥1 year of follow-up
data
Egan BM, Bandyopadhyay D, Shaftman SR, Wagner CS, Zhao Y, Yu-Isenberg KS. Hypertension. 2012;59:1124-1131.
2
Main results
 The majority of patients completed the year on
their initial treatment category
 Patients who ended on free combinations included
both those on free combinations only and those on
≥2 free-dose medications with a single-pill
combination
 The single-pill combination group had higher:
•
•
•
•
Body mass index
Proportion of females
Proportion of patients with stage 2 hypertension
Proportion of patients with BP ≥20/10 mm Hg above goal
Egan BM, Bandyopadhyay D, Shaftman SR, Wagner CS, Zhao Y, Yu-Isenberg KS. Hypertension. 2012;59:1124-1131.
3
Single-pill combination better
than free combination
Single-pill combination
Free combination
Control rate
Monotherapy
68%
59%
59%
Days to control
Egan BM, Bandyopadhyay D, Shaftman SR, Wagner CS, Zhao Y, Yu-Isenberg KS. Hypertension. 2012;59:1124-1131.
4
Conclusion
 Hypertensive patients begun on single-pill
combinations were 53% more likely than those
started on monotherapy to attain BP control in the
first year.
 Despite starting with higher untreated BP, patients
who began treatment with single-pill combinations
were more likely to achieve BP control than those
started on free combination or monotherapy
 Greater use of single-pill combinations as initial
therapy improves hypertension control and
cardiovascular outcomes in the first year of treatment.
Egan BM, Bandyopadhyay D, Shaftman SR, Wagner CS, Zhao Y, Yu-Isenberg KS. Hypertension. 2012;59:1124-1131.
5