AchievemenT of target resting HEart rate on beta-blockers in patients with stable angiNA and hypertension (ATHENA) in routine clinical practice in Russia

Objectives: The primary objective of this study was to establish the proportion of patients with stable angina and arterial hypertension on beta-blocker (BB) treatment reaching target resting heart rates (RHR) of 55-60 beats per min in clinical cardiology and general practice in Russia. Secondary objectives included the association between achievement of target RHR and mean BB doses, Seattle Angina Questionnaire (SAQ) scores and achievement of target blood pressure (BP) levels (systolic/diastolic BP <140/90mmHg). Research design and methods: ATHENA (AchievemenT of target resting HEart rate on beta-blockers in patients with stable angiNA and hypertension) was a non-interventional, cross-sectional, observational study conducted in 20 sites in Russia (NCT01321242). The study population comprised patients aged ≥18 years with stable angina (class I-III) and primary hypertension, on BB treatment for ≥2 months prior to enrollment. Results: Of 399 study participants, 62 (15.5%; 95% confidence interval [CI]: 0.121 to 0.195) achieved target RHR. Clinical characteristics associated with significant differences between subgroups achieving and not achieving target RHR were systolic BP (131.1 vs 138.2mmHg, P=0.006), diastolic BP (78.6 vs 83.5mmHg, P<0.001) and frequency of nitroglycerin administration (1.5% vs 3.0%, P=0.045). Most patients were taking bisoprolol (48.9%) and metoprolol (36.1%), with mean daily doses of 5.5mg and 73.7mg, respectively. Median SAQ scores were: 52.8 physical limitation, 50.0 angina stability, 60.0 angina frequency, 75.0 treatment satisfaction, 50.0 disease perception (quality of life) and 59.6 total score, with no significant differences between subgroups. Patients achieving target RHR were significantly more likely also to achieve target BP, compared with patients not achieving target RHR (72.6% vs 53.4%; P=0.005; odds ratio: 2.309; 95% CI: 1.270 to 4.197). Conclusion: In a Russian population with stable angina and hypertension on BB treatment, RHR control was suboptimal. ClinicalTrials.gov identifier: NCT01321242. © 2014 All rights reserved.

Number of issue
5
Language
English
Pages
805-811
Status
Published
Volume
30
Year
2014
Organizations
  • 1 Department of Cardiology and Clinical Pharmacology, Hospital 64, Peoples' Friendship University of Russia, Vavilova Street 61, Moscow, 117292, Russian Federation
  • 2 AstraZeneca, Moscow, Russian Federation
Keywords
Adrenergic beta-antagonists; Angina,stable; Antihypertensive agents; Cardiovascular diseases/drug therapy; Epidemiologic studies; Heart rate; Hypertension
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