Guideline-Recommended Antihypertensive Therapy Combinations Are Underused

In a recent study, researchers investigated antihypertensive prescribing practices and the effectiveness of recommended 2-drug combinations on blood pressure (BP) control.

Specific combinations of 2 drug classes, based upon complimentary mechanisms or benefits for a concomitant disease, are recommended for the management of hypertension. However, how often these combinations are utilized and how these trends are affected by the effectiveness of BP control is less well understood.

For their study, the researchers used data from the electronic health records of 27,579 patients with hypertension and defined BP control as a BP <140/90 mm Hg. Overall, BP control was 65% among the participants and preferred dual antihypertensive therapy was prescribed in 55% of patients with uncomplicated hypertension, 49% of those with diabetes, and 47% of those with a history of myocardial infarction.

“[T]hese prescribing frequencies of preferred combinations were not explained by worse BP control on those combinations,” the researchers wrote. “In fact, we found suggestive evidence of association between prescribing of preferred two drug classes and improved BP control among post-MI (OR: 1.21, 95% CI: 0.99–1.48, P = 0.061) and uncomplicated hypertensive (OR: 1.11, 95% CI: 0.98–1.26, P = 0.089) patients.”

—Michael Potts

Reference:
Magvanjav O, Cooper-Dehoff RM, McDonough CW, et al. Combination antihypertensive therapy prescribing and blood pressure control in a real-world setting. AJH. 2020;33(4):316-324.