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Article

Gender Differences in Non-Persistence with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among Older Hypertensive Patients with Peripheral Arterial Disease

by
Martin Wawruch
1,*,
Jan Murin
2,
Tomas Tesar
3,
Martina Paduchova
4,
Miriam Petrova
1,
Denisa Celovska
2,
Beata Havelkova
5,
Michal Trnka
6,
Lucia Masarykova
3,*,
Sofa D. Alfian
7,8 and
Emma Aarnio
9
1
Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, 811 08 Bratislava, Slovakia
2
1st Department of Internal Medicine, Faculty of Medicine, Comenius University, 813 69 Bratislava, Slovakia
3
Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, 832 32 Bratislava, Slovakia
4
Department of Angiology, Health Centre, 917 01 Trnava, Slovakia
5
General Health Insurance Company, 851 04 Bratislava, Slovakia
6
Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, 813 72 Bratislava, Slovakia
7
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor 45363, Indonesia
8
Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor 45363, Indonesia
9
School of Pharmacy, University of Eastern Finland, 70211 Kuopio, Finland
*
Authors to whom correspondence should be addressed.
Biomedicines 2022, 10(7), 1479; https://doi.org/10.3390/biomedicines10071479
Submission received: 11 May 2022 / Revised: 15 June 2022 / Accepted: 19 June 2022 / Published: 22 June 2022
(This article belongs to the Special Issue Advances in Cardiovascular Pharmacology: The Era of Targeted Therapies in Cardiology)
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Abstract

The beneficial effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in hypertensive patients with peripheral arterial disease (PAD) depends on long-term persistence. The aims of our study were to analyse gender differences in non-persistence with ACEIs/ARBs, and to identify the characteristics associated with the likelihood of non-persistence. Our study cohort included 7080 hypertensive patients (4005 women and 3075 men) aged ≥65 years, treated with ACEIs/ARBs, in whom PAD was diagnosed between 1 January and 31 December 2012. Non-persistence was identified according to a treatment gap of 6 months without ACEI/ARB prescriptions. The characteristics associated with non-persistence were identified using the Cox regression model. At the end of the 5-year follow-up, 23.2% of the whole study cohort, 22.3% of men, and 23.9% of women were non-persistent with ACEIs/ARBs, with no significant gender differences in persistence. While a number of characteristics were associated with non-persistence, only three characteristics had consistent, statistically significant associations in both genders: being a new ACEI/ARB user increased the likelihood of non-persistence, and general practitioner as index prescriber and increasing the overall number of medications decreased the likelihood of non-persistence. Information on the differences in characteristics that are associated with non-persistence between genders may help to better identify patients for whom special attention should be paid to improve their persistence.
Keywords: peripheral arterial disease; adherence; persistence; angiotensin-converting enzyme inhibitors; angiotensin receptor blockers; general practitioner; new user; arterial hypertension; older patient peripheral arterial disease; adherence; persistence; angiotensin-converting enzyme inhibitors; angiotensin receptor blockers; general practitioner; new user; arterial hypertension; older patient

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MDPI and ACS Style

Wawruch, M.; Murin, J.; Tesar, T.; Paduchova, M.; Petrova, M.; Celovska, D.; Havelkova, B.; Trnka, M.; Masarykova, L.; Alfian, S.D.; et al. Gender Differences in Non-Persistence with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among Older Hypertensive Patients with Peripheral Arterial Disease. Biomedicines 2022, 10, 1479. https://doi.org/10.3390/biomedicines10071479

AMA Style

Wawruch M, Murin J, Tesar T, Paduchova M, Petrova M, Celovska D, Havelkova B, Trnka M, Masarykova L, Alfian SD, et al. Gender Differences in Non-Persistence with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among Older Hypertensive Patients with Peripheral Arterial Disease. Biomedicines. 2022; 10(7):1479. https://doi.org/10.3390/biomedicines10071479

Chicago/Turabian Style

Wawruch, Martin, Jan Murin, Tomas Tesar, Martina Paduchova, Miriam Petrova, Denisa Celovska, Beata Havelkova, Michal Trnka, Lucia Masarykova, Sofa D. Alfian, and et al. 2022. "Gender Differences in Non-Persistence with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among Older Hypertensive Patients with Peripheral Arterial Disease" Biomedicines 10, no. 7: 1479. https://doi.org/10.3390/biomedicines10071479

APA Style

Wawruch, M., Murin, J., Tesar, T., Paduchova, M., Petrova, M., Celovska, D., Havelkova, B., Trnka, M., Masarykova, L., Alfian, S. D., & Aarnio, E. (2022). Gender Differences in Non-Persistence with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among Older Hypertensive Patients with Peripheral Arterial Disease. Biomedicines, 10(7), 1479. https://doi.org/10.3390/biomedicines10071479

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