Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey

Robert J Petrella,1–3 Dawn P Gill,2,3 Jean-Pascal Berrou4On behalf of the POWER survey Study Group 1Departments of Family Medicine, Medicine (Cardiology) and Kinesiology, University of Western Ontario, London, ON, Canada; 2Aging, Rehabilitation and Geriatric Care Research Centre,...

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Autores principales:	Petrella RJ, Gill DP, Berrou JP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/840d2732eb7942baa09e580f317ba571
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spelling	oai:doaj.org-article:840d2732eb7942baa09e580f317ba5712021-12-02T03:40:52ZEffect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey1178-7007https://doaj.org/article/840d2732eb7942baa09e580f317ba5712015-03-01T00:00:00Zhttp://www.dovepress.com/new-effect-of-eprosartan-based-antihypertensive-therapy-on-corona-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007 Robert J Petrella,1–3 Dawn P Gill,2,3 Jean-Pascal Berrou4On behalf of the POWER survey Study Group 1Departments of Family Medicine, Medicine (Cardiology) and Kinesiology, University of Western Ontario, London, ON, Canada; 2Aging, Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, London, ON, Canada; 3Department of Family Medicine and School of Health Studies, University of Western Ontario, London, ON, Canada; 4Abbott Products Operations AG, Allschwil, Switzerland Objective: As part of the Physicians’ Observational Work on Patient Education According to their Vascular Risk (POWER) survey, we used Framingham methodology to examine the effect of an eprosartan-based regimen on total coronary heart disease (CHD) risk in diabetic patients recruited in Canada. Methods: Patients with new or uncontrolled hypertension (sitting systolic blood pressure [SBP] >140 mmHg with diastolic blood pressure <110 mmHg) were identified at 335 Canadian primary care practices. Initial treatment consisted of eprosartan 600 mg/day, which was later supplemented with other antihypertensives as required. Outcomes included change in SBP at 6 months (primary objective) and absolute change in the Framingham 10-year CHD risk score (secondary objective). Results: We identified an intention-to-treat diabetes population of 195 patients. Most diabetic patients were prescribed two or more antihypertensive drugs throughout the survey. Mean reductions in SBP and diastolic blood pressure were 20.8±14.8 mmHg and 9.5±10.7 mmHg, respectively. The overall absolute mean 10-year CHD risk, calculated using Framingham formulae, declined by 2.9±3.5 points (n=49). Average baseline risk was higher in men than women (14.8±8.6 versus 5.6±1.8 points); men also had a larger average risk reduction (4.2±4.3 versus 1.5±1.3 points). The extent of absolute risk reduction also increased with increasing age (trend not statistically significant). Conclusion: Eprosartan-based therapy substantially reduced arterial blood pressure in our subset of diabetic patients; while there was a slight reduction in Framingham risk, there are indications from our data that both blood pressure control and the wider management of CHD risk in diabetic patients remains suboptimal in Canadian primary care. Keywords: cardiovascular risk, hypertension, diabetes, eprosartan, FraminghamPetrella RJGill DPBerrou JPDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2015, Iss default, Pp 173-180 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Petrella RJ Gill DP Berrou JP Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey
description	Robert J Petrella,1–3 Dawn P Gill,2,3 Jean-Pascal Berrou4On behalf of the POWER survey Study Group 1Departments of Family Medicine, Medicine (Cardiology) and Kinesiology, University of Western Ontario, London, ON, Canada; 2Aging, Rehabilitation and Geriatric Care Research Centre, Lawson Health Research Institute, London, ON, Canada; 3Department of Family Medicine and School of Health Studies, University of Western Ontario, London, ON, Canada; 4Abbott Products Operations AG, Allschwil, Switzerland Objective: As part of the Physicians’ Observational Work on Patient Education According to their Vascular Risk (POWER) survey, we used Framingham methodology to examine the effect of an eprosartan-based regimen on total coronary heart disease (CHD) risk in diabetic patients recruited in Canada. Methods: Patients with new or uncontrolled hypertension (sitting systolic blood pressure [SBP] >140 mmHg with diastolic blood pressure <110 mmHg) were identified at 335 Canadian primary care practices. Initial treatment consisted of eprosartan 600 mg/day, which was later supplemented with other antihypertensives as required. Outcomes included change in SBP at 6 months (primary objective) and absolute change in the Framingham 10-year CHD risk score (secondary objective). Results: We identified an intention-to-treat diabetes population of 195 patients. Most diabetic patients were prescribed two or more antihypertensive drugs throughout the survey. Mean reductions in SBP and diastolic blood pressure were 20.8±14.8 mmHg and 9.5±10.7 mmHg, respectively. The overall absolute mean 10-year CHD risk, calculated using Framingham formulae, declined by 2.9±3.5 points (n=49). Average baseline risk was higher in men than women (14.8±8.6 versus 5.6±1.8 points); men also had a larger average risk reduction (4.2±4.3 versus 1.5±1.3 points). The extent of absolute risk reduction also increased with increasing age (trend not statistically significant). Conclusion: Eprosartan-based therapy substantially reduced arterial blood pressure in our subset of diabetic patients; while there was a slight reduction in Framingham risk, there are indications from our data that both blood pressure control and the wider management of CHD risk in diabetic patients remains suboptimal in Canadian primary care. Keywords: cardiovascular risk, hypertension, diabetes, eprosartan, Framingham
format	article
author	Petrella RJ Gill DP Berrou JP
author_facet	Petrella RJ Gill DP Berrou JP
author_sort	Petrella RJ
title	Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey
title_short	Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey
title_full	Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey
title_fullStr	Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey
title_full_unstemmed	Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey
title_sort	effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by framingham methodology in canadian patients with diabetes: results of the power survey
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/840d2732eb7942baa09e580f317ba571
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Effect of eprosartan-based antihypertensive therapy on coronary heart disease risk assessed by Framingham methodology in Canadian patients with diabetes: results of the POWER survey

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