Background Seven angiotensin receptor blocker(ARB) have been marketed, making it a therapeutic group capable of therapeutic exchange at the hospital. Losartan,irbesartan,candesartan and valsartan are available in the ’Hospital’s Pharmacotherapeutic Guide(HPG) of our centre. Losartan is the ARB of choice for therapeutic exchanges based on efficiency criteria.
Purpose The aim of this study is to analyse the effectiveness of ARB in hospitalised patients as a function of the ARB prescribed at admission.
Material and methods A cross-sectional study was conducted in September 2017. All patients admitted to units with pharmaceutical validation were selected for treatment with any ARB available in the HPG and retrospectively. ARB home prescriptions were assessed, at admission, systolic blood pressure(SBP) and diastolic blood pressure (DBP) throughout the stay if it was <10 days or for a maximum of 10 days if it was higher and prescribed diet. It was defined as hypertension if SBP >139 if the age was <80 years or >149 if the age >80 years and/or if DBP >89. It was defined as hypotension if SBP <90 and/or if the DSP<60.
Results We selected 48 patients, 18% of all patients admitted. Eight patients had no ARB prescribed at home. Twenty per cent (n=8) were >80 years: 10% (n=4) were diagnosed on entry of cardiovascular and ischaemic pathologies. The median stay was 12. 5±13. 5 days. The diet was 67% unsalted. A mean of blood pressure records was obtained of 14. 5±7. 4 (2/patient/day). The efficacy data are shown in the following table:
Conclusion The most frequent alteration was hyperSBP. In the group of patients that maintained the same treatment prior to admission, there was a tendency to hyperSBP and hyperDBP, whereas hypotension was more frequent in the group where treatment was modified.
These data suggest that therapeutic exchanges have no impact on the effectiveness of ARB.
No conflict of interest
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