YAKHAK HOEJI (약학회지)

The Pharmaceutical Society of Korea (대한약학회)
권호 표지

Evaluation of Therapeutic Differences of Angiotensin II Receptor Blockers and Calcium Channel Blockers Among Hypertensive Patients Classified by Oriental Traditional Way

한국적 의학 기준에 근거한 고혈압환자의 Angiotensin II Receptor Blockers와 Calcium Channel Blockers의 약물 평가

  • Lee, Ok Sang (Laboratory of Clinical Pharmacy, Colleage of Pharmacy, Chungbuk National University) ;
  • Cheon, Young Ju (Laboratory of Clinical Pharmacy, College of Pharmacy, The Catholic University of Korea) ;
  • Ye, Kyong Nam (Laboratory of Clinical Pharmacy, College of Pharmacy, The Catholic University of Korea) ;
  • Yoon, Hee Young (Laboratory of Clinical Pharmacy, College of Pharmacy, The Catholic University of Korea) ;
  • Kim, Jung Tae (College of Pharmacy, Kyung Hee University Hospital at Gangdong) ;
  • Lee, Yun Jeong (College of Pharmacy, Dankook University) ;
  • Lim, Sung Cil (Laboratory of Clinical Pharmacy, College of Pharmacy, The Catholic University of Korea)
  • 이옥상 (충북대학교 약학대학) ;
  • 천영주 (가톨릭대학교 약학대학) ;
  • 예경남 (가톨릭대학교 약학대학) ;
  • 윤희영 (가톨릭대학교 약학대학) ;
  • 김정태 (경희대학교 약학대학, 강동경희대학교병원) ;
  • 이윤정 (단국대학교 약학대학) ;
  • 임성실 (가톨릭대학교 약학대학)
  • Received : 2014.03.03
  • Accepted : 2014.03.31
  • Published : 2014.04.30
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Abstract

Background: Oriental lifestyle for treating diseases has been developed and well-accepted for a long time among Koreans. Sasang Constitution theory, originated from Korean traditional medicine, suggests that medication treatment should be differentiated by each patient's body classification (So-yang [SY], So-eum [SE], Tae-yang [TY], and Tae-eum [TE]), in contrary to western medicine's theory that medication should be applied equally by disease indication without such classification. However, the pharmacotherapeutic outcomes of these theories have not been compared to date. In this study, we aimed to compare the two theories by evaluating blood pressure (BP), which is lowered as a therapeutic outcome, among hypertensive patients taking angiotensin II receptor blockers (ARBs) or calcium channel blockers (CCBs), two most commonly used antihypertensive classes in Korea. Methods: From April 2006 to June 2012, we retrospectively collected data on hypertensive patients with Sasang Constitution classification at Kyunghee University Hospital at Gangdong, one of the East-West collaborative medical centers in Korea. We collected information on age, gender, underlying diseases, antihypertensive drugs (ARB, CCB, ARB+CCB), and BP by reviewing the electronic medical records. We excluded patients with missing blood pressure at baseline or follow-up, or those who had a change in their antihypertensive drug class during follow-up. Results: We selected a total of 573 patients (SY: 165, SE: 158, TY: 0, TE: 250). Baseline BPs were on average 139.0/82.0 mmHg for SY, 137.8/78.5 mmHg for SE, and 138.7/79.2 mmHg for TE. In all three groups, CCBs were the most prescribed, followed by combination therapy with ARB+CCB, then ARBs. BP reduction after 1 month of initial medication was significantly different among the drug classes, but not in Sasang constitutional classification (ARB [SY: -12.4/-4.7, SE: -12.3/-2.5, TE: -8.6/-1.8], CCB [SY: -12.3/-5.4, SE: -13.0/-2.3, TE: -10.8/-6.0], ARB+CCB [SY: -15.6/-6.7, SE: -18.4/-8.1, TE: -20.2/-6.7], drug [$P{\leq}0.05$/P>0.05], constitutional type [P>0.05/P>0.05]). Conclusion: We observed significant differences in reduction of blood pressure by classes of drugs (ARB+CCB>CCB>ARB) but not by Sasang constitutional classification. Therefore, current approach of antihypertensive pharmacotherapy assisted by Western medicine is appropriate for treatment of hypertension. However, further larger scale or prospective studies are required in order to confirm these results.

Keywords

References

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