Single Pill Combination sebagai Lini Pertama Terapi Hipertensi dan Proteksi Kardiovaskular
DOI:
https://doi.org/10.55175/cdk.v50i2.530Kata Kunci:
Hipertensi, luaran kardiovaskular, single pill combination, tatalaksanaAbstrak
Sebagian besar pasien hipertensi membutuhkan 2 hingga 3 obat untuk dapat mencapai target terapeutik yang disarankan oleh berbagai organisasi ahli. Penggunaan single pill combination (SPC) merupakan salah satu solusi untuk meningkatkan kepatuhan pasien demi kontrol hipertensi yang adekuat. Efek anti-hipertensi kombinasi 2 obat dari kelas mekanisme kerja yang berbeda 2-5 kali lipat lebih tinggi dibandingkan monoterapi, serta dosis dapat dikurangi untuk menghindari efek samping obat. Berbagai studi kohort retrospektif menunjukkan bahwa penggunaan SPC dapat meningkatkan kepatuhan minum obat, menurunkan angka kematian dan rawat inap akibat penyakit kardiovaskular. Penggunaan SPC perlu mempertimbangkan fleksibilitas, akses, serta kemampuan finansial pasien.
Patient with hypertension mostly need 2 or 3 medications to achieve the recommended therapeutic target. The use of single pill combination (SPC) is one of the solution to improve adherence and achieve adequate control of hypertension. The anti-hypertensive effects of dual combination from different classes drugs can achieve 2 to 5 times higher than monotherapy, and dose reduction of each drug in combination therapy might avoid adverse effects. Many retrospective cohort studies have found that the utilization of SPC improved patients’ adherence and decrease mortality and hospital admission rate due to cardiovascular events. SPC usage needs to consider flexibility, access, and patient’s financial status.
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Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International society of hypertension global hypertension practice guidelines. Hypertension. 2020;75(6):1334–57.
Iellamo F, Werdan K, Narkiewicz K, Rosano G, Volterrani M. Practical Applications for single pill combinations in the cardiovascular continuum. Card Fail Rev.2017;03(01):40.
Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal. 2018;39:3021–104.
An J, Derington CG, Luong T, Olson KL, King JB, Bress AP, et al. Fixed-Dose Combination medications for treating hypertension: a review of effectiveness, safety, and challenges. Curr Hypertens Rep. 2020;22:95.
Perhimpunan Dokter Hipertensi Indonesia. Konsensus penatalaksanaan hipertensi 2021: update konsensus PERHI 2019. Jakarta: BP PERHI. 2021.
Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Trends Cardiovasc Med. 2020;30:160–164.
Geldsetzer P, Manne-Goehler J, Marcus ME, Ebert C, Zhumadilov Z, Wesseh CS, et al. The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults. Lancet. 2019;394(10199):652–62.
Bruyn E, Nguyen L, Schutte AE, Murphy A, Perel P, Webster R. Implementing single-pill combination therapy for hypertension: a scoping review of key health system requirements in 30 low-and middle-income countries. Global Heart. 2022;17(1):6.
Guerrero-García C, Rubio-Guerra AF. Combination therapy in the treatment of hypertension. Drugs Context. 2018;7:212531.
Monthly Index of Medical Specialties (MIMS). Search Drug Information, Interactions, Images, Dosage & Side Effects. MIMS Indonesia. Available from: https://www.mims.com/indonesia/
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–520.
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2018;71(19):e127–248.
Smith DK, Lennon RP, Carlsgaard PB. Managing hypertension using combination therapy. Am Fam Physician. 2020;101(6):341-349.
DiPette DJ, Skeete J, Ridley E, Campbell NRC, Lopez-Jaramillo P, Kishore SP, et al. Fixed-dose combination pharmacologic therapy to improve hypertension control worldwide: Clinical perspective and policy implications. J Clin Hypertens. 2019;21:4–15.
Parati G, Kjeldsen S, Coca A, Cushman WC, Wang J. Adherence to single-pill versus free-equivalent combination therapy in hypertension: a systematic review and meta-analysis. Hypertension. 2021;77:692–705.
Wilke T, Weisser B, Predel HG, Schmieder R, Wassmann S, Gillessen A, et al. Effects of single pill combinations compared to identical multi pill therapy on outcomes in hypertension, dyslipidemia and secondary cardiovascular prevention: The START-Study. Integr Blood Press Control. 2022;15:11–21.
Simons LA, Chung E, Ortiz M. Long-term persistence with single-pill, fixed-dose combination therapy versus two pills of amlodipine and perindopril for hypertension: Australian experience. Curr Med Res Opin. 2017;33(10):1783–7.
Panjabi S, Lacey M, Bancroft T, Cao F. Treatment adherence, clinical outcomes, and economics of triple-drug therapy in hypertensive patients. J Am Soc Hypertens. 2013;7(1):46–60.
Tung YC, Huang YC, Wu LS, Chang CJ, Chu PH. Medication compliance and clinical outcomes of fixed-dose combinations vs free combinations of an angiotensin II receptor blocker and a calcium channel blocker in hypertension treatment. J Clin Hypertens. 2017;19(10):983–9.
Verma AA, Khuu W, Tadrous M, Gomes T, Mamdani MM. Fixed-dose combination antihypertensive medications, adherence, and clinical outcomes: A population based retrospective cohort study. PLOS Med. 2018;15(6):e1002584.
Zhang Z, Yu Y, Asayama K, Hansen T, Maestre G, Staessen J. Starting antihypertensive drug treatment with combination therapy. Hypertension. 2021;77:789–99.
Hsiao FC, Tung YC, Chou SH, Wu LS, Lin CP, Wang CL, et al. Fixed-Dose combinations of renin-angiotensin system inhibitors and calcium channel blockers in the treatment of hypertension: A comparison of angiotensin receptor blockers and angiotensin-converting enzyme inhibitors. Medicine. 2015;94(51)
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