| Comparative effectiveness of angiotensin-converting enzyme inhibitors versus beta-blockers as second-line therapy for hypertension. | |
| | |
MedLine Citation:
|
PMID: 20716714 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
BACKGROUND: Trials comparing hypertension monotherapies have found either no difference or modest differences in blood pressure (BP) and cardiovascular events. However, no trial has assessed the comparative effectiveness of 2nd-line therapy in patients whose BP was not controlled with a thiazide diuretic. METHODS AND RESULTS: This was an observational study conducted with a hypertension registry of adults enrolled in 3 large integrated health care delivery systems from 2002 to 2007. Patients newly started on thiazide monotherapy whose BP remained uncontrolled were observed after addition of either an angiotensin-converting enzyme (ACE) inhibitor or β-blocker for subsequent BP control and cardiovascular events. Patients for whom either add-on drug was indicated or contraindicated were excluded. After adjustment for patient characteristics and study year, BP control during the subsequent 6 to 18 months was comparable for the 2 agents (70.5% ACE, 69.0% β-blockers; P=0.09). Rates of incident myocardial infarction (hazard ratio, 1.05; 95% confidence interval, 0.69 to 1.58) and stroke (hazard ratio, 1.01; 95% confidence interval, 0.68 to 1.52) were also similar for the ACE inhibitor and β-blocker groups during an average of 2.3 years of follow-up. There were also no differences in heart failure or renal function. CONCLUSIONS: ACE inhibitors and β-blockers are equally effective in lowering BP and preventing cardiovascular events for patients whose BP is not controlled with a thiazide diuretic alone and who have no compelling indication for a specific 2nd-line agent. |
| | |
Authors:
|
David J Magid; Susan M Shetterly; Karen L Margolis; Heather M Tavel; Patrick J O'Connor; Joe V Selby; P Michael Ho |
Related Documents
:
|
9524044 - Short-term effects of withdrawing angiotensin converting enzyme inhibitor therapy on ho... 3759424 - Overestimation of blood pressure in the elderly. 11224004 - The spatial qrs-t angle as a marker of ventricular repolarisation in hypertension. 11411734 - Evaluation of the placebo effect and reproducibility of blood pressure measurement in h... 6112844 - Blood pressure and pulse response to insulin-induced hypoglycemia during non-selective ... 2758944 - Perforation of the rectum and sigmoid colon during barium-enema examination. management... |
Publication Detail:
|
Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. Date: 2010-08-17 |
Journal Detail:
|
Title: Circulation. Cardiovascular quality and outcomes Volume: 3 ISSN: 1941-7705 ISO Abbreviation: Circ Cardiovasc Qual Outcomes Publication Date: 2010 Sep |
Date Detail:
|
Created Date: 2010-09-15 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101489148 Medline TA: Circ Cardiovasc Qual Outcomes Country: United States |
Other Details:
|
Languages: eng Pagination: 453-8 Citation Subset: IM |
Affiliation:
|
Institute for Health Research, Kaiser Permanente Colorado, University of Colorado, 10065 E Harvard Ave., Denver, CO 80231, USA. David.J.Magid@kp.org |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Feeling Vigorous and the Risks of All-Cause Mortality, Ischemic Heart Disease, and Diabetes: A 20-Ye...
Next Document: Optimal medical therapy for non-ST-segment-elevation acute coronary syndromes: exploring why physici...