MANAGEMENT OF HYPERTENSION- INSIGHTS INTO REAL-WORLD CLINICAL PRACTICE FOR DIFFERENTIAL USAGE OF CALCIUM CHANNEL BLOCKERS (CCBS)
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 38
Abstract
BACKGROUND Calcium channel blockers (CCB) like amlodipine, S (-) amlodipine and cilnidipine, etc. have established place in the treatment of hypertension (HTN). As perceived by most of the physicians, they have comparative antihypertensive efficacy. However, available evidences suggest varied differences in incidence of pedal oedema. Aim- This survey was planned to understand real-world clinical practice pattern of Indian physicians for usage of various antihypertensive agents with emphasis on CCBs and whether differential incidence of oedema with CCBs is encountered in their clinical practice. MATERIALS AND METHODS Survey questionnaire consisting of 10 questions about preferred antihypertensive choice for different subsets of patients with HTN and efficacy and safety of S (-) amlodipine was prepared and validated in small group of physicians. Overall, 494 general physicians and cardiologists practising in India were approached for seeking their opinion on usage of various CCBs. Statistical Analysis- Data were expressed in percentage. Design- Prospective, cross sectional, questionnaire-based survey. RESULTS Amongst various anti-hypertensive agents, majority of the physicians preferred CCB as their initial drug of choice for patients with HTN (53.8%), HTN with CKD (41.1%), elderly (55.3%), and young (30.8%) patients. Though amlodipine was preferred by 75.7% physicians, pedal oedema was observed in >10% patients by 40.5% physicians. Most of the physicians rated S (-) amlodipine to have better efficacy (79.4%) and safety profile (88.3%) with decreased incidence of pedal oedema than racemic Amlodipine. CONCLUSION Available evidences suggest comparative efficacy of S (-) amlodipine and racemic amlodipine with varied differences in incidence of pedal oedema. However, our survey suggests better efficacy and safety of S (-) amlodipine over racemic amlodipine as opined by most of the physicians of India. The survey findings need to be further evaluated in randomised clinical trials.
Authors and Affiliations
Arup Dasbiswas, Tushar Tamboli, Shahu Ingole, Swati Naik, Rishi Jain
Keywords
Related Articles
- EP ID EP219131
- DOI 10.18410/jebmh/2017/451
- Views 82
- Downloads 0
ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ORGANISMS CAUSING SURGICAL SITE INFECTIONS (SSI)
BACKGROUND CDC defines surgical site infection as ‘Infections related to operative procedure that occurs at or near surgical incision within 30 days of operative procedure or within one year if the implant is left in sit...
MR ARTIFACTS
BACKGROUND Artifacts in MRI image are produced as a result of various factors related to the machine and the subject undergoing MRI. Artifacts not only affect the quality of images, but also lead to misinterpretation of...
A STUDY OF CLINICAL AND RADIOLOGICAL OUTCOME OF PROXIMAL THIRD TIBIAL FRACTURES MANAGED BY LOCKING COMPRESSION PLATE
BACKGROUND There has been a disturbing rise in the number of road traffic accidents ever since the advent of high-speed transportation, with an increased number of orthopaedic related problems. Proximal tibia has a vital...
A STUDY TO ASSESS THE FACTORS DETERMINING THE UNMET NEED FOR CONTRACEPTIVE USAGE IN AN URBAN AREA RAJAPUR
Family planning is a “way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes, and responsible decisions by individuals and couples, in order to promote the health and welfare of th...
A STUDY TO EVALUATE THE PREVALENCE OF OCULAR MORBIDITY OF SCHOOL GOING CHILDREN (6-16 YEARS) IN DURGAPUR, WEST BENGAL
BACKGROUND School eye screening children is useful in detecting correctable causes of defective vision, especially refractive errors (myopia) and minimizing long-term visual disability. Ocular disorders such as refractiv...