Results

Figure 1. The evolution of blood pressure values for all study patients evaluated through “network analysis”

Background Cardiovascular diseases represent the main cause of premature death in industrialized countries and their prevalence has been increased also in the developing countries. Although most patients with mild to moderate hypertension are asymptomatic, the quality of life is affected because of associated conditions and complexity of therapy.The symptoms of hypertension are vague. Common complaints as: headache, dizziness, tiredness are not considered serious symptoms by the patients, but they may impair patient’s daily life. Moreover, end-organ damage induced by hypertension complicates the course of the disease, causing more symptoms and deterioration of patient’s life.

The aim of the study was to determine, by applying Markov mathematical prediction model, the probability of hypertensive patients, after the treatment, to normalize their blood pressure values and how the disease can affect their life expectancy.

Methods: 289 patients, diagnosed with essential arterial hypertension, were evaluated at the Cardiology Clinic “Ascar” Timișoara, from June 2012 until May 2013. According to the type of antihypertensive medicine administrated, they were divided into three groups: group A (106 patients) treated with nebivolol, group B (104 patients) with perindopril and group C (79 patients) with candesartan cilexetil. Systolic and diastolic pressure values were evaluated at baseline, 6 and 12 months of treatment.

The present study demonstrates that by applying Markov model, hypertensive patients treatedwith candesartan cilexetil present the longest survival period. This mathematical method ofprediction may provide clues to the patients life expectancy, being useful in clinical practicebut also in specific clinical studies.

Conclusion

Table 1. Demographic and clinical data of the study group (n=289)

No. Demographic and clinical

characteristics

Group A (nebivolol)(no=106)

Group B (perindopril)

(no=104)

Group C (candesartan)

cilexetil(no=79)

p

1Age (years)

(median±DS)55.13±9.03 58.88±11.0 58.90±16.06 0.038

2 Female/male (no.) 54/52 57/47 51/28 0.173

3. Smokers (no.) 17 11 7 0.937

4.Alcohol consumers

(no.)35 44 37 0.142

5. Diet (no.) 10 6 8 0.496

6. Diabetics (no.) 9 20 17 0.029

7.Initial systolic blood

pressure value (median±DS)

148.21±16.2 150.79±14.65 148.45±25.10 0.552

8.Initial diastolic boold

pressure value (median±DS)

86.74±9.43 87.87±9.71 88.16±12.58 0.607

9.Left ventricular

hypertrophy (no.)44 48 37 0.791

10.Distolic dysfunction

(no.)74 57 50 0.079

11.Cardiovascular risk: moderate/high/very

high (no.)36/50/16 22/39/32 13/19/42 0.0008

BA

C D

Variation in systolic blood pressure (A, B) and diastolic (C, D) blood pressure of the study patients before and after treatment (green spots represent patients with normal blood pressure values and red spots represent patients with high pressure values).

After 12 months of treatment, 68.25% of hypertensive patients treated with candesartan cilexetil, 52.04% of those treated with perindopril and 46.93% of those treated with nebivolol had normalised blood pressure values.

Considering these data and the incidence of hypertensive pathology in Romanian population, according to the Sephar I and II studies, after the application of Markov predictive method,  a life expectancy of 11.46 years, 12.04 years and 13.88 years was obtain for patients treated with nebivolol, perindopril and candesartan cilexetil, respectively.

EVALUATION OF ANTIHYPERTENSIVE TREATMENT EFFICACY USING THE PREDICTIVE MARKOV MODEL

Liana Suciu1, Carmen Cristescu 1, Lucreția Udrescu3, Mirela Voicu1, Lenuța-Maria Șuta4, M. Udrescu5, Valentina Buda1, Mirela Tomescu2

1Universitatea de Medicină și Farmacie “Victor Babeș” Timișoara, Farmacologie-Farmacie Clinică, Facultatea de Farmacie, Timișoara, Romania2Universitatea de Medicină și Farmacie “Victor Babeș” Timișoara, Semiologie Medicală II, Facultatea de Medicină, Timișoara, Romania3Universitatea de Medicină și Farmacie “Victor Babeș” Timișoara, Controlul Medicamentului, Facultatea de Farmacie, Timișoara, Romania4Universitatea de Medicină și Farmacie “Victor Babeș” Timișoara, Tehnologie Farmaceutică, Biofarmacie și Farmacinetică, Facultatea Farmacie, Timișoara, Romania5Universitatea Politehnica, Calculatoare, Timișoara, Romania

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