Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients
Hypertension in Mexico has a prevalence of 32% and is the second most widespread cause of consultation in primary care. Only 40% of patients in treatment have a blood pressure (BP) below 140/90 mmHg. This clinical trial aimed to compare the effectiveness of the combination of enalapril and nifedipin...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/10/6/243 |
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| author | Humberto Badillo-Alonso Marisol Martínez-Alanis Ramiro Sánchez-Huesca Abel Lerma Claudia Lerma |
| author_facet | Humberto Badillo-Alonso Marisol Martínez-Alanis Ramiro Sánchez-Huesca Abel Lerma Claudia Lerma |
| author_sort | Humberto Badillo-Alonso |
| collection | DOAJ |
| description | Hypertension in Mexico has a prevalence of 32% and is the second most widespread cause of consultation in primary care. Only 40% of patients in treatment have a blood pressure (BP) below 140/90 mmHg. This clinical trial aimed to compare the effectiveness of the combination of enalapril and nifedipine versus the empirical treatment for hypertension in patients with uncontrolled BP in a primary care center in Mexico City. Participants were randomized to treatment with enalapril and nifedipine (combination group) or to continue with the empirical treatment. Outcome variables were BP control, therapeutic adherence, and adverse effects at 6 months of follow-up. At the end of the follow-up period, BP control (64% versus 77%) and therapeutic adherence (53% versus 93%) showed an improvement from the baseline values in the group that received the combination treatment. BP control (51% versus 47%) and therapeutic adherence (64% versus 59%) in the group who received the empirical treatment did not show improvement from the baseline to follow-up. Combined treatment was 31% more efficacious than conventional empirical treatment (odds ratio = 3.9), which yielded an incremental clinical utility of 18% with high tolerability extent among patients in primary care in Mexico City. These results contribute to the control of arterial hypertension. |
| first_indexed | 2024-03-11T02:19:39Z |
| format | Article |
| id | doaj.art-ac07de18348e42ae80203312745fe681 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-11T02:19:39Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-ac07de18348e42ae80203312745fe6812023-11-18T10:57:27ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252023-05-0110624310.3390/jcdd10060243Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care PatientsHumberto Badillo-Alonso0Marisol Martínez-Alanis1Ramiro Sánchez-Huesca2Abel Lerma3Claudia Lerma4Centro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan Edo. de Mexico 52786, MexicoSchool of Engineering, Universidad Anahuac Mexico, Huixquilucan 52786, MexicoInstituto Nacional de Cardiologia Ignacio Chávez, Mexico City 04480, MexicoInstitute of Health Sciences, Universidad Autónoma del Estado de Hidalgo, San Agustín Tlaxiaca 42160, MexicoCentro de Investigación en Ciencias de la Salud (CICSA), FCS, Universidad Anáhuac México Campus Norte, Huixquilucan Edo. de Mexico 52786, MexicoHypertension in Mexico has a prevalence of 32% and is the second most widespread cause of consultation in primary care. Only 40% of patients in treatment have a blood pressure (BP) below 140/90 mmHg. This clinical trial aimed to compare the effectiveness of the combination of enalapril and nifedipine versus the empirical treatment for hypertension in patients with uncontrolled BP in a primary care center in Mexico City. Participants were randomized to treatment with enalapril and nifedipine (combination group) or to continue with the empirical treatment. Outcome variables were BP control, therapeutic adherence, and adverse effects at 6 months of follow-up. At the end of the follow-up period, BP control (64% versus 77%) and therapeutic adherence (53% versus 93%) showed an improvement from the baseline values in the group that received the combination treatment. BP control (51% versus 47%) and therapeutic adherence (64% versus 59%) in the group who received the empirical treatment did not show improvement from the baseline to follow-up. Combined treatment was 31% more efficacious than conventional empirical treatment (odds ratio = 3.9), which yielded an incremental clinical utility of 18% with high tolerability extent among patients in primary care in Mexico City. These results contribute to the control of arterial hypertension.https://www.mdpi.com/2308-3425/10/6/243hypertension controlprimary careclinical trial |
| spellingShingle | Humberto Badillo-Alonso Marisol Martínez-Alanis Ramiro Sánchez-Huesca Abel Lerma Claudia Lerma Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients Journal of Cardiovascular Development and Disease hypertension control primary care clinical trial |
| title | Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients |
| title_full | Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients |
| title_fullStr | Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients |
| title_full_unstemmed | Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients |
| title_short | Effectiveness of the Combination of Enalapril and Nifedipine for the Treatment of Hypertension versus Empirical Treatment in Primary Care Patients |
| title_sort | effectiveness of the combination of enalapril and nifedipine for the treatment of hypertension versus empirical treatment in primary care patients |
| topic | hypertension control primary care clinical trial |
| url | https://www.mdpi.com/2308-3425/10/6/243 |
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