Aims: Recent data showed an alarming rise of new dialysis cases secondary to diabetic nephropathy despite the growing usage of RAAS blockers. Primary objective of this study is to explore the prevalence of RAAS blockers usage among type II diabetic patients, secondary objectives are to compare the prescribing pattern of RAAS blocker between primary and tertiary care center and to explore if the dose of RAAS blocker prescribed was at optimal dose as suggested by trials.
Materials And Methods: This is a retrospective study conducted at one public tertiary referral hospital and one public health clinic in Sungai Petani, Kedah, Malaysia.
Results: RAAS blockers in T2DM patients was found to be 65%. In primary care, 14.3% of the RAAS blockers prescribed was ARB. Tertiary care had higher utilization of ARB, which was 42.9%. In primary care setting, the most commonly used ACEI were perindopril (92.4%) followed by enalapril (7.6%), meanwhile perindopril was the only ACEI being prescribed in tertiary care. The most prescribed ARB was irbesartan (63.6%) and telmisartan (54.2%) respectively in primary and tertiary care. Overall, 64.9% of RAAS blockers prescribed by both levels of care were found to be achieving the target dose as recommended in landmark trials. Crude odd ratio of prescribing RAAS blocker in primary care versus tertiary care was reported as 2.70 (95% CI: 1.49 to 4.91).
Conclusion: RAAS blockers usage among T2DM patients was higher in primary care versus tertiary care settings. Majority of the patients did not receive optimal dose of RAAS blockers.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.dsx.2017.12.005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Osteoporotic fracture risks of thiazides and dihydropyridines in angiotensin modulator users.
Osteoporos Int
December 2024
Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan.
Unlabelled: This study examined the impact of thiazide and RAAS antihypertensive medications vs DHP-RAAS medications on fracture risk. The close alignment of such settings with clinical use, combined with the potential bone benefits of ACEis and ARBs, provides enhanced accuracy in bone health evidence.
Purpose: To determine whether thiazides, combined with either angiotensin-converting enzyme inhibitor (ACEi) or angiotensin II receptor blocker (ARB), offer bone-protective benefits compared with dihydropyridine (DHP) drugs combined with ACEi or ARB.
CARVEDILOL IN PATIENTS WITH UNCONTROLLED AND RESISTANT ARTERIAL HYPERTENSION.
Georgian Med News
October 2024
2Department of Cardiology, Chapidze Heart Center, Tbilisi, Georgia.
Background: The use of beta-blockers in treating resistant hypertension remains poorly understood. While PATHWAY-2 showed a systolic blood pressure benefit with bisoprolol, further research is needed to evaluate other beta-blockers in terms of the effect of systolic blood pressure, assess diastolic blood pressure effects, and guide management in patients intolerant to CCBs as well.
Objectives: Our study aimed to evaluate the efficacy of Carvedilol (non-selective beta-blocker with alpha-1 blocking function) in the management of resistant hypertension, including in patients intolerant to calcium channel blockers.
Comparative Efficacy and Long-Term Outcomes of Beta-Blockers Alone or in Combination With Angiotensin-Converting Enzyme (ACE) Inhibitors in Chronic Heart Failure: A Systematic Review.
Cureus
November 2024
Internal Medicine, Nishtar Medical University, Multan, PAK.
This systematic review provides a comprehensive comparison of beta-blockers and angiotensin-converting enzyme (ACE) inhibitors in the management of chronic heart failure (CHF), with a focus on their long-term efficacy and safety profiles. By synthesizing evidence from randomized controlled trials (RCTs) and clinical studies, the review highlights the significant benefits of both drug classes in reducing mortality and hospital readmissions, and improving patient outcomes. Beta-blockers, such as bisoprolol and carvedilol, demonstrated superior efficacy in reducing sudden cardiac death, particularly in patients with heart failure with reduced ejection fraction (HFrEF).
View Article and Find Full Text PDFImpact of hyperkalaemia on renin-angiotensin-aldosterone (RAAS) inhibitor reduction or withdrawal following hospitalisation.
Clin Exp Med
December 2024
Department of Medicine, King's College Hospital NHS Foundation Trust, London, UK.
Background: Inhibitors of the renin-angiotensin-aldosterone system (RAAS), such as ACE inhibitors (ACEi), angiotensin-II receptor blockers and mineralocorticoid receptor antagonists, reduce morbidity and mortality in hypertension, congestive heart failure and chronic kidney disease. However, their use can lead to hyperkalaemia. We examined the proportions of RAAS inhibitor (RAASi) reduction or withdrawal, across GFR strata, following hospitalisation and the effect on patient mortality.
View Article and Find Full Text PDFAssociations of renal sinus fat with metabolic parameters, abdominal visceral adipose tissue, metabolic syndrome, fructose intake, and blood pressure control in obese individuals with hypertension: a cross-sectional study.
J Nutr Sci
December 2024
Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Renal sinus fat (RSF) crucially influences metabolic regulation, inflammation, and vascular function. We investigated the association between RSF accumulation, metabolic disorders, and nutritional status in obese individuals with hypertension. A cross-sectional study involved 51 obese hypertensive patients from Salamat Specialized Community Clinic (February-September 2022).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!