frequency of Antihypertensive Drug Classes and Single-Pill Combinations in Obese Patients: An 8-Year retrospective Study
Obesity is a notable factor in the development and progression of hypertension, substantially elevating cardiovascular risk. Despite the increasing prevalence of obesity, specific guidelines for managing hypertension in obese patients are lacking. Current European and Polish guidelines, established since 2018, advocate for the use of single-pill combinations (SPCs) throughout all stages of hypertension treatment.
This retrospective study investigated antihypertensive treatment patterns in obese patients over an eight-year period. Focusing on a high-risk subgroup with unique physiological characteristics and limited specific therapeutic guidance, the analysis was restricted to obese patients undergoing preoperative evaluation for bariatric surgery. Medical records where reviewed for 233 obese hypertensive patients, categorized into two cohorts: those diagnosed with hypertension before 2020 and those diagnosed in 2020 or later.
Results revealed a notable increase in the use of three or more antihypertensive medications, alongside a rise in prescriptions for beta-blockers and angiotensin receptor blockers after 2020. However, SPC utilization remained surprisingly low. Two-drug SPCs were prescribed for 35.6% of patients, and three-drug SPCs for only 11.2%, with no statistically significant change in these rates over the study period. The study also noted the introduction of SGLT2 inhibitors into treatment regimens following 2020.
These findings demonstrate a clear gap between established clinical guidelines and actual prescribing practices.Increased adherence to existing recommendations, notably regarding SPCs, could perhaps improve both therapeutic outcomes and medication adherence within this vulnerable, high-risk patient population.
Keywords: antihypertensive agents; drug therapy; guideline adherence; hypertension; obesity.