Therapeutic exchange of angiotensin II receptor antagonists in patients hospitalised in a traumatology unit

Márquez-Peiró, J.F.; Porta-Oltra, B.; Borrás-Almenar, C.

doi:10.1016/S2173-5085(09)70071-1

Farmacia Hospitalaria

ISSN: 1130-6343

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Analytical, observational, prospective, longitudinal study with pre-post analysis. Patients undergoing AIIRA treatment who were not included in the hospital's pharmacotherapeutic guide were included in the study over those who had undergone a normalised therapeutic exchange of AIIRA. Variable response: proportion of patients whose blood pressure levels (BP levels) remained within the established therapeutic aim for the prevention of cardiovascular accidents. Other variables: systolic and diastolic blood pressure values (SBP and DBP) in the month prior to hospitalisation and after therapeutic exchange, antihypertensive medication, comorbidities.

Results

Thirty-seven patients were included in the study. Following therapeutic exchange, 81.08% maintained BP values within the range established by the European Society of Hypertension-European Society of Cardiology Committee. SBP difference: 4.82 (95% confidence interval [CI], −1.09 to 10.74; P=.107); DBP difference: −0.15 (95% CI, −3.27 to 2.97; P=.924), and therefore not clinically significant.

Conclusions

The normalised procedure for therapeutic exchange of AIIRA is effective and safe for patients in terms of maintaining BP, which allows for adequate control of BP during the hospital stay.

Keywords:

Angiotensin II receptor antagonists

Therapeutic exchange

Arterial hypertension

Resumen

Objetivo

Analizar la proporción de pacientes que mantiene los valores de presión arterial (PA) dentro del objetivo terapéutico establecido para reducir el riesgo cardiovascular tras el intercambio terapéutico de antagonistas del receptor de angiotensina II (ARA-II).

Métodos

Estudio observacional, analítico, prospectivo y longitudinal, con análisis pre-post. Se incluyeron pacientes en tratamiento con ARA-II no incluidos en la guía farmacoterapéutica del hospital en los que se realizó un intercambio terapéutico normalizado de ARA-II. Variable respuesta: proporción de pacientes que mantienen los valores de PA dentro del objetivo terapéutico establecido para la prevención de accidentes cardiovasculares. Otras variables: valores de PA sistólica (PAS) y diastólica (PAD) el mes previo al ingreso y tras el intercambio terapéutico, medicamentos antihipertensivos, comorbilidades.

Resultados

Se incluyó a 37 pacientes. Tras el intercambio terapéutico el 81,08% de los pacientes mantiene los valores de PA dentro del objetivo establecido por la European Society of Hypertension-European Society of Cardiology Committee. Diferencia PAS: 4,82 (intervalo de confianza [IC] del 95 %, −1,09 a 10,74; p=0,107); diferencia PAD: −0,15 (IC del 95 %, −3,27 a 2,97; p=0,924) y, por tanto, sin significación clínica.

Conclusiones

El procedimiento normalizado para intercambio terapéutico de ARA-II es efectivo y seguro para los pacientes en términos de mantenimiento de la PA, permitiendo un adecuado control de la PA durante la estancia hospitalaria.

Palabras clave:

Antagonistas del receptor de angiotensina II

Intercambio terapéutico

Hipertensión arterial

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