Therapeutic inertia was calculated by evaluating the proportion of visits at which sBP was above the target for eligible visits minus the proportion of visits where the change was made in antihypertensive treatment (AHT), either medication type or dose, over the number of eligible visits, with the resultant value multiplied by the mean of the difference between the actual sBP and the target value at clinic visits. At the last visit, 76 patients out of 217 at the first visit had dBP >90вЂ‰mmHg (35%) that is, dBP control was 65%. At the last visit, 281 out of 413 patients at the first visit had sBP >140вЂ‰mmHg (68%) that is, sBP control was 32%.

The most significant decrease of both sBP and dBP was associated with treatment using 3-drug combination of telmiвЂ‰+вЂ‰hydroвЂ‰+вЂ‰spironolactone (41 and 16вЂ‰mmHg, resp.), telmiвЂ‰+вЂ‰hydroвЂ‰+вЂ‰nitre (34 and 15вЂ‰mmHg, resp.), and telmiвЂ‰+вЂ‰hydroвЂ‰+вЂ‰urapidil (34 and 15вЂ‰mmHg, resp.). The most significant decrease of dBP was associated with treatment by nitre, hydro, telmi, and verapamil (>10вЂ‰mmHg). The most significant decrease of sBP was associated with treatment by nitre, hydro, telmi, and urapidil (>19вЂ‰mmHg). The drugs used most frequently were perindopril (perin), nitrendipine (nitre), amlodipine (amlo), telmisartan (telmi), hydrochlorothiazide (hydro), rilmenidine, and nebivolol (used in >100 patients). 15% of patients were treated using hypertension monotherapy, 70% of patients were treated using 2- to 4-drug combination therapy, and 15% of patients were treated using 5- to 6-drug combination. The final number of patients for analysis who fulfilled the inclusion criteria for interpenetration of both diagnostic circles was 570. Our goals were to evaluate the effectivity of hypertension treatment as for drug choice, decrease of sBP and dBP associated with a certain drug, a drug combination, and therapeutic inertia in patients with metabolic syndrome and/or diabetes mellitus. The analysis included 13,990 visit records, and the average number of visits per patient was 8.5вЂ‰В±вЂ‰7.0. We have analysed the database of 1,595 consecutive patients visiting our department of cardiology and internal medicine clinic in 2005вЂ“2014.

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