Monitoring of Adverse Drug Reactions in Patients Receiving 2 types of RAS Blockage (ACEI/ARB) in the Treatment of Hypertension
Adverse Drug Reactions in the Treatment of Hypertension
Keywords:
hyperkalemia, renin angiotensin system blockage, hypertensionAbstract
The combination of Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Blockers (ARBs) in hypertension treatment is one of indicators in hospital project promotes Rational Drugs Use. The hypertensive treatment guidelines in general practice 2019 does not recommend combination of ACEIs and ARBs because of increasing risk of adverse drug reactions. This research was to compare occurrence of hyperkalemia in patients receiving ACEIs and ARBs compared with patients receiving only one group of ACEIs or ARBs. Medical records database was collected, most of patients were female (49.6%), older than 70 years (51%). About half (52.2%) of patients treated with ACEIs and ARBs had hypertension alone while 35% of patients who received ACEIs had chronic kidney disease with hypertension and 52.9% of patients receiving ARBs had chronic kidney disease with hypertension. About four-fifths of three groups of patients had normal blood potassium levels. However, combination of ACEIs and ARBs group had one quarter of incidence of mild hyperkalemia. Therefore, median of serum potassium levels in three groups were not different. Patient's comorbidity and drug contraindications should be considered for appropriate medication. ACEIs and ARBs should not be used together because of increasing risk of hyperkalemia rather than using one group of ACEIs or ARBs.
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