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Effectiveness and Tolerability of a Trandolapril-Based Antihypertensive Treatment Regimen over 12 months in Actual Clinical Care Across Canada

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Abstract

Background and Objectives

There is little information on the effects of trandolapril on renal function when used in Canadian general practice. We evaluated the use and blood pressure (BP) lowering effectiveness of trandolapril-based therapies in Canadian conditions of actual care and attempted to capture assessments of urinary albumin concentration (UAC) and estimated glomerular filtration rate (eGFR) in clinical practice.

Methods

This was a prospective, non-interventional, observational study in adults with uncontrolled hypertension, with or without co-morbidities, either treatment-naïve or uncontrolled on existing antihypertensive medications. Hypertension was not defined per protocol. Trandolapril doses (0.5, 1, 2, 4 mg) and subjects’ continued medical care were all at the discretion of the treating physician. Data were gathered after 3, 6 and 12 months.

Results

7,993 patients entered the study and 4,983 patients attended the Month 12 visit. Most patients (91.7 %) received trandolapril as a new prescription. At 12 months, 72.9 % of patients without diabetes and 34.4 % with diabetes were controlled (targets <140/90 and 130/80 mmHg, respectively) and 79.2 % of patients with diabetes had BP below 140/90 mmHg. Evaluable eGFR data were available for 25.1, 21.2 and 21.7 % of patients at Months 3, 6 and 12, respectively, and UAC data for 9.6, 8.2 and 9.0 % of patients at the same time points. Treatment was well tolerated. Dropout rates were 37.7 % after 12 months.

Conclusion

Effective, sustained and well-tolerated double-digit BP reduction is achievable with a trandolapril-based treatment regimen for all patient groups. It appears that for diabetic patients blood pressure control as per Canadian Hypertension Education Program recommendations is yet challenging. The results also illuminate the persistent gap between treatment guidelines and actual care.

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Acknowledgments

The in-MAU-tion study was supported by Abbott Canada. R.T. has received consulting fees from Abbott. E.B. has received lecture fees and travel support from Abbott. J.M. and A.V. are employees of Abbott. The authors are grateful to Pelle Stolt for help with medical writing and revisions to the manuscript.

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Authors and Affiliations

  1. Hamilton Health Sciences, 700 Main Str E, Hamilton, ON, Canada

    Richard Tytus

  2. Department of Medicine, University of Calgary, Calgary, AB, Canada

    Ellen Burgess

  3. Abbott, Ludwigshafen am Rhein, Germany

    Julia Maurer

  4. Abbott, Saint-Laurent, QC, Canada

    Anita Vanjaka

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  1. Richard Tytus
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  2. Ellen Burgess
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  4. Anita Vanjaka
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Correspondence to Richard Tytus.

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Tytus, R., Burgess, E., Maurer, J. et al. Effectiveness and Tolerability of a Trandolapril-Based Antihypertensive Treatment Regimen over 12 months in Actual Clinical Care Across Canada. Clin Drug Investig 33, 535–543 (2013). https://doi.org/10.1007/s40261-013-0092-y

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