Disclosures All authors completed the ICMJE Uniform Disclosure Forms for Potential Conflicts of Interest, which are retained by the corresponding author. Dr. Verpooten has held board memberships with, served as a consultant to, and received research grants from Novartis. Drs. Aerts, Coen and Vancayzeele and Ms. Hermans are employees of Novartis. Drs. MacDonald, Abraham and Lee and Mr. Bowles are employees of Matrix45 and by company policy are prohibited from owning equity in client organisations (except through mutual funds or other independently administered collective investment instruments) or contracting independently with client organisations. Matrix45 provides similar services to those described in this article to other biopharmaceutical companies on a non-exclusivity basis.
Antihypertensive effectiveness of aliskiren for the ‘real-world’ management of hypertension: multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study)
Article first published online: 13 DEC 2010
© 2010 Blackwell Publishing Ltd
International Journal of Clinical Practice
Volume 65, Issue 1, pages 54–63, January 2011
How to Cite
Verpooten, G. A., Aerts, A., Coen, N., Vancayzeele, S., Hermans, C., Bowles, J., MacDonald, K., Abraham, I. and Lee, C. S. (2011), Antihypertensive effectiveness of aliskiren for the ‘real-world’ management of hypertension: multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study). International Journal of Clinical Practice, 65: 54–63. doi: 10.1111/j.1742-1241.2010.02562.x
- Issue published online: 13 DEC 2010
- Article first published online: 13 DEC 2010
- Paper received June 2010, accepted November 2010
Aims: The ‘DRIVER’ study was designed to investigate the ‘real-world’ effectiveness of aliskiren-based treatment of hypertension. This article reports the 180-day blood pressure (BP) outcomes, and the multilevel (physician- and patient-level) determinants thereof.
Methods and results: DRIVER was a prospective, observational, open-label, multi-centre, pharmaco-epidemiologic study of hypertensive patients treated with aliskiren in whom prior treatment failed or was not tolerated. 2070 patients (enrolled by 426 physicians) were enrolled; 1695 patients (81.9%) completed the 180-day aliskiren treatment period. Mean patient age was 64.2 ± 12.1 years; 53.7% were men, 25.3% diabetic and 40.7% had a high or very high cardiovascular (CV) risk. At 180 days, the mean ± SD reductions in systolic and diastolic BP were −22.9 ± 16.7 mmHg and −10.5 ± 10.9 mmHg respectively (both p < .001). 2007 and 2009 guideline-defined BP control was achieved in 36.4% and 56.3% of patients, respectively (both p < .001). 64.2% of eligible patients had a reduction in CV risk (p < .001). A physician-level class effect was responsible for 22.8% and 28.1% of variability in systolic and diastolic BP, respectively, for 20.1% of variability in BP control, and for 16.1% of variability in the reduction of CV risk. Both patient- (e.g. adherence) and physician-related factors (e.g. age and knowledge) were significant in profiling best response to treatment with aliskiren. Adverse events reported in this article were consistent with the aliskiren scientific leaflet.
Conclusion: Aliskiren is safe and effective in reducing BP, improving BP control and reducing global CV risk in a ‘real-world’ setting and for patients in whom prior treatment failed or was not tolerated. Optimising treatment adherence and strategic medical education may be ways of improving BP outcomes in patients with hypertension.