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Suitability of antiplatelet therapy in hypertensive patients

Journal of Human Hypertension volume 29, pages 40–45 (2015)Cite this article

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Abstract

Antiplatelet therapy (AT) is indicated in hypertensive patients with increased cardiovascular risk. The literature about the adequate or inadequate prescription of AT is scarce. We conducted a prospective descriptive study to quantify therapeutic inertia and non-guideline-recommended prescription (NGRP) of AT (aspirinor clopidogrel or both), and to assess associated factors, calculating the adjusted odds ratios (ORs) from multivariate models. In 2007–2009, 712 primary health-care hypertensive patients in a Spanish region were enrolled. Inertia was defined as the lack of an AT prescription, despite being indicated by guidelines, whereas NGRP was defined as AT prescription when there was no guideline recommendation. We also recorded cardiovascular variables. Inertia and NGRP were quantified for primary and secondary prevention. Of 108 patients in secondary prevention, 53 had inertia (49.1%, 95% confidence interval (CI): 39.6–58.5%). Associated profile: female (OR=0.460, P=0.091), no dyslipidemia (OR=0.393, P=0.048), no coronary heart disease (OR=0.215, P=0.001) and high diastolic blood pressure (OR=1.076, P=0.016). In primary prevention, NGRP was present in 69 of 595 patients (11.6%, 95% CI: 9.0–14.2%). Associated profile: male (OR=1.610, P=0.089), smoking (OR=2.055, P=0.045), dyslipidemia (OR=3.227, P<0.001) and diabetes (OR=2.795, P<0.001). Although certain factors were clearly associated with these phenomena much still remains to be learnt.

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Acknowledgements

We thank everyone who has contributed to the scientific content of the manuscript or provided technical support is in this section. We also thank the Conselleria de Sanitat (Valencian Community) for allowing us to use the equipment of the health centers and the computerized health system. We also thank Armina Sepehri for collaboration in the data computerization process, and Ian Johnstone for help with the English language version of the text. A research grant from the Department of Clinical Medicine at Miguel Hernández University was used to buy reagents for biochemical testing. This was the only role of the funding sources in the study.

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Authors and Affiliations

  1. Miguel Martínez Community Pharmacy, Benimantell, Spain

    M J Martínez-Orozco

  2. Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain

    M J Martínez-Orozco, Z Perseguer-Torregrosa, V F Gil-Guillén, A Palazón-Bru, D Orozco-Beltran & C Carratalá-Munuera

  3. Zeneida Perseguer Community Pharmacy, Petrel, Spain

    Z Perseguer-Torregrosa

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  1. M J Martínez-Orozco
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Correspondence to A Palazón-Bru.

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Martínez-Orozco, M., Perseguer-Torregrosa, Z., Gil-Guillén, V. et al. Suitability of antiplatelet therapy in hypertensive patients. J Hum Hypertens 29, 40–45 (2015). https://doi.org/10.1038/jhh.2014.25

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