Comparison of Efficacies of Commonly Used Hypertension Treatment Modalities: A Retrospective Study of 1900 Participants in a Hypertension Clinic.

BACKGROUND Although various antihypertensive medications are available, some hypertensive patients have uncontrolled blood pressures, especially in the clinic. The aim of the present study was to compare the efficacies of various antihypertensive therapies in our hypertension (HTN) clinic (monotherapy vs. combination therapy, fixed-dose combination (FDC) versus free equivalent combination (FEC), and diuretics versus non-diuretics. MATERIAL AND METHODS In this retrospective study, patients at the HTN clinic of the Third Xiangya Hospital with primary hypertension were enrolled from June 2016 to February 2017. Data on participants' basic characteristics, blood pressure data, and treatment modalities were collected. The proportions of participants attaining target blood pressure after treatment with antihypertensive modalities were calculated and compared. RESULTS Among 1900 participants, combination therapy had a better control efficacy than monotherapy (P<0.0005). When HTN was treated by 2 kinds of drugs, FEC was used much more frequently than FDC (P<0.0005). In grade 3 HTN, FDC had a higher control rate (P=0.002). If more than 2 kinds of drugs were used, FDC+OTHER had a slightly higher control rate in grade 2 and 3 (42.1% vs. 38.5%, P=0.724; 36.2% vs. 31.0%, P=0.526, respectively). Therapies with diuretics had better control rates than those without diuretics (43.1% vs. 36.9%, P=0.025). CONCLUSIONS In our clinic, FEC was prescribed more often than FDC. When blood pressure is significantly elevated, especially at levels 2 or 3, FDC seems to have a better control rate than FEC. Therapies with diuretics controlled HTN more efficiently.