CONTROL RATE ACCORDING TO THERAPEUTIC OBSERVANCE IN A COHORT OF HYPERTENSIVE PATIENTS TREATED WITH A COMBINATION OF TELMISARTAN AND HYDROCHLOROTHIAZIDE: PROTECT PLUS STUDY

Objectives: The purpose of this study was to compare the control rate according to the observance assessed by the questionnaire of the French Committee of Fight Against Hypertension (CFLHTA) including 6 questions. Method: PROTECT PLUS is an pharmaco-epidemiologic study with assessment of the observance. An observance was rated as good if the patient answered “NOT” all the questions, average if he answered “YES” one or two questions and poor if there were more than two answers “YES”. Results: 3443 patients out of 4255 were included in the analysis. Observance was good for 34.2% of the patients, average for 56.1% and poor for 9.7%. We observed a significant difference on control rate (SBP/DBP < 140/90 mm Hg) with 38.2%,44.8% and 48.0% of control rate for poor, average and good observance respectively (p = 0.0004). The patients having a poor observance were more sedentary compared to the patients having a good observance. In the same way, they were more often and significantly diabetics and dyslipidemic, had more abdominal obesity and consumed more alcohol than the patients with a good observance. “Poor observing” had more often left ventricular hypertrophy and microalbuminuria than “good observing”; furthermore, they had significantly more history of Stroke/TIA and peripheral artery disease. Conclusion: More than half of the patients was not correctly observing. One found a significant correlation between observance and control rate of blood pressure. Unfortunately the population of “poor observing”, which had weakest control rate, was also which had the most comorbidities and more at high-risk of developing cardiovascular events. An increased sensibilization of this high-risk population to the therapeutic observance by educational programs and specific follow up appear to be essential.