A novel treatment algorithm using fractional, liquid, transdermal, and off-label medications reduced office blood pressure by 17±5/9±3 mm Hg (P<.01, P<.05) at 12 months in patients with MDI-HTN.
Observational (n=55)
No
Does a novel treatment algorithm using alternative formulations and dosing strategies reduce blood pressure in patients with multiple antihypertensive drug intolerances?
A stratified medicine approach using alternative formulations and dosing strategies can significantly lower blood pressure in patients with multiple antihypertensive drug intolerances.
p-value: p=<.01
Multiple drug intolerance to antihypertensive medications (MDI-HTN) is an overlooked cause of nonadherence. In this study, 55 patients with MDI-HTN were managed with a novel treatment algorithm utilizing sequentially initiated monotherapies or combinations of maximally tolerated doses of fractional tablet doses, liquid formulations, transdermal preparations, and off-label tablet medications. A total of 10% of referred patients had MDI-HTN, resulting in insufficient pharmacotherapy and baseline office blood pressure (OBP) of 178±24/94±15 mm Hg. At baseline, patients were intolerant to 7.6±3.6 antihypertensives; they were receiving 1.4±1.1 medications. After 6 months on the novel MDI-HTN treatment algorithm, both OBP and home blood pressure (HBP) were significantly reduced, with patients receiving 2.0±1.2 medications. At 12 months, OBP was reduced from baseline by 17±5/9±3 mm Hg (P<.01, P<.05) and HBP was reduced by 11±5/12±3 mm Hg (P<.01 for both) while patients were receiving 1.9±1.1 medications. Application of a stratified medicine approach allowed patients to tolerate increased numbers of medications and achieved significant long-term lowering of blood pressure.
Antoniou et al. (Wed,) conducted a observational in Hypertension with multiple drug intolerances (MDI-HTN) (n=55). Novel treatment algorithm (fractional, liquid, transdermal, and off-label medications) was evaluated on Reduction in office blood pressure (OBP) and home blood pressure (HBP) at 12 months (p=<.01). A novel treatment algorithm using fractional, liquid, transdermal, and off-label medications reduced office blood pressure by 17±5/9±3 mm Hg (P<.01, P<.05) at 12 months in patients with MDI-HTN.