Antihypertensive effectiveness of aliskiren for the 'real-world' management of hypertension: Multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study)

G. A. Verpooten, A. Aerts, N. Coen, S. Vancayzeele, C. Hermans, J. Bowles, K. MacDonald, Ivo L Abraham, C. S. Lee

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Aims: The 'DRIVER' study was designed to investigate the 'real-world' effectiveness of aliskiren-based treatment of hypertension. This article reports the 180-day blood pressure (BP) outcomes, and the multilevel (physician- and patient-level) determinants thereof. Methods and results: DRIVER was a prospective, observational, open-label, multi-centre, pharmaco-epidemiologic study of hypertensive patients treated with aliskiren in whom prior treatment failed or was not tolerated. 2070 patients (enrolled by 426 physicians) were enrolled; 1695 patients (81.9%) completed the 180-day aliskiren treatment period. Mean patient age was 64.2 ± 12.1 years; 53.7% were men, 25.3% diabetic and 40.7% had a high or very high cardiovascular (CV) risk. At 180 days, the mean ± SD reductions in systolic and diastolic BP were -22.9 ± 16.7 mmHg and -10.5 ± 10.9 mmHg respectively (both p <.001). 2007 and 2009 guideline-defined BP control was achieved in 36.4% and 56.3% of patients, respectively (both p <.001). 64.2% of eligible patients had a reduction in CV risk (p <.001). A physician-level class effect was responsible for 22.8% and 28.1% of variability in systolic and diastolic BP, respectively, for 20.1% of variability in BP control, and for 16.1% of variability in the reduction of CV risk. Both patient- (e.g. adherence) and physician-related factors (e.g. age and knowledge) were significant in profiling best response to treatment with aliskiren. Adverse events reported in this article were consistent with the aliskiren scientific leaflet. Conclusion: Aliskiren is safe and effective in reducing BP, improving BP control and reducing global CV risk in a 'real-world' setting and for patients in whom prior treatment failed or was not tolerated. Optimising treatment adherence and strategic medical education may be ways of improving BP outcomes in patients with hypertension.

Original languageEnglish (US)
Pages (from-to)54-63
Number of pages10
JournalInternational Journal of Clinical Practice
Volume65
Issue number1
DOIs
StatePublished - Jan 2011

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Antihypertensive Agents
Blood Pressure
Hypertension
Physicians
Therapeutics
aliskiren
Age Factors
Risk Reduction Behavior
Patient Compliance
Medical Education
Epidemiologic Studies
Guidelines

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Antihypertensive effectiveness of aliskiren for the 'real-world' management of hypertension : Multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study). / Verpooten, G. A.; Aerts, A.; Coen, N.; Vancayzeele, S.; Hermans, C.; Bowles, J.; MacDonald, K.; Abraham, Ivo L; Lee, C. S.

In: International Journal of Clinical Practice, Vol. 65, No. 1, 01.2011, p. 54-63.

Research output: Contribution to journalArticle

Verpooten, G. A. ; Aerts, A. ; Coen, N. ; Vancayzeele, S. ; Hermans, C. ; Bowles, J. ; MacDonald, K. ; Abraham, Ivo L ; Lee, C. S. / Antihypertensive effectiveness of aliskiren for the 'real-world' management of hypertension : Multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study). In: International Journal of Clinical Practice. 2011 ; Vol. 65, No. 1. pp. 54-63.
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abstract = "Aims: The 'DRIVER' study was designed to investigate the 'real-world' effectiveness of aliskiren-based treatment of hypertension. This article reports the 180-day blood pressure (BP) outcomes, and the multilevel (physician- and patient-level) determinants thereof. Methods and results: DRIVER was a prospective, observational, open-label, multi-centre, pharmaco-epidemiologic study of hypertensive patients treated with aliskiren in whom prior treatment failed or was not tolerated. 2070 patients (enrolled by 426 physicians) were enrolled; 1695 patients (81.9{\%}) completed the 180-day aliskiren treatment period. Mean patient age was 64.2 ± 12.1 years; 53.7{\%} were men, 25.3{\%} diabetic and 40.7{\%} had a high or very high cardiovascular (CV) risk. At 180 days, the mean ± SD reductions in systolic and diastolic BP were -22.9 ± 16.7 mmHg and -10.5 ± 10.9 mmHg respectively (both p <.001). 2007 and 2009 guideline-defined BP control was achieved in 36.4{\%} and 56.3{\%} of patients, respectively (both p <.001). 64.2{\%} of eligible patients had a reduction in CV risk (p <.001). A physician-level class effect was responsible for 22.8{\%} and 28.1{\%} of variability in systolic and diastolic BP, respectively, for 20.1{\%} of variability in BP control, and for 16.1{\%} of variability in the reduction of CV risk. Both patient- (e.g. adherence) and physician-related factors (e.g. age and knowledge) were significant in profiling best response to treatment with aliskiren. Adverse events reported in this article were consistent with the aliskiren scientific leaflet. Conclusion: Aliskiren is safe and effective in reducing BP, improving BP control and reducing global CV risk in a 'real-world' setting and for patients in whom prior treatment failed or was not tolerated. Optimising treatment adherence and strategic medical education may be ways of improving BP outcomes in patients with hypertension.",
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AU - Aerts, A.

AU - Coen, N.

AU - Vancayzeele, S.

AU - Hermans, C.

AU - Bowles, J.

AU - MacDonald, K.

AU - Abraham, Ivo L

AU - Lee, C. S.

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