| Initial monotherapy and combination therapy and hypertension control the first year. | |
| | |
MedLine Citation:
|
PMID: 22566499 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Initial antihypertensive therapy with single-pill combinations produced more rapid blood pressure control than initial monotherapy in clinical trials. Other studies reported better cardiovascular outcomes in patients achieving lower blood pressure during the first treatment year. We assessed the effectiveness of initial antihypertensive monotherapy, free combinations, and single-pill combinations in controlling untreated, uncontrolled hypertensives during their first treatment year. Electronic record data were obtained from 180 practice sites; 106 621 hypertensive patients seen from January 2004 to June 2009 had uncontrolled blood pressure, were untreated for ≥ 6 months before therapy, and had ≥ 1 one-year follow-up blood pressure data. Control was determined by the first follow-up visit with blood pressure <140/<90 mm Hg for patients without diabetes mellitus or chronic kidney disease and <130/<80 mm Hg for patients with either or both conditions. Multivariable hazards regression ratios (HRs) and 95% CIs for time to control were calculated, adjusting for age, sex, baseline blood pressure, body mass index, diabetes mellitus, chronic kidney disease, cardiovascular disease, initial therapy, final blood pressure medication number, and therapeutic inertia. Patients on initial single-pill combinations (N = 9194) were more likely to have stage 2 hypertension than those on free combinations (N = 18 328) or monotherapy (N = 79 099; all P<0.001). Initial therapy with single-pill combinations (HR, 1.53 [95% CI, 1.47-1.58]) provided better hypertension control in the first year than free combinations (HR, 1.34; [95% CI, 1.31-1.37]) or monotherapy (reference) with benefits in black and white patients. Greater use of single-pill combinations as initial therapy may improve hypertension control and cardiovascular outcomes in the first treatment year. |
| | |
Authors:
|
Brent M Egan; Dipankar Bandyopadhyay; Stephanie R Shaftman; C Shaun Wagner; Yumin Zhao; Kristina S Yu-Isenberg |
Related Documents
:
|
17867479 - Intraocular pressure after phacoemulsification using hydroxypropyl methylcellulose and ... 20529079 - Buphthalmos: early glaucoma history. 19920669 - Rapid visual recovery and long-term intraocular pressure control after donor scleral pa... 14769599 - Intravitreal reinjection of triamcinolone for exudative age-related macular degeneration. 655539 - Introduction of the ocusert ocular system to an ophthalmic practice. 8795769 - Resuturing the scleral flap leads to resolution of hypotony maculopathy. 12484509 - Epidemiologic study of the association of low-km mitochondrial acetaldehyde dehydrogena... 12357279 - The autonomic nervous system and pressure-natriuresis in cardiovascular-renal interacti... 23671599 - Factors associated with prevalence, awareness, treatment and control of hypertension am... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. Date: 2012-05-07 |
Journal Detail:
|
Title: Hypertension Volume: 59 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2012 Jun |
Date Detail:
|
Created Date: 2012-05-17 Completed Date: 2012-07-25 Revised Date: 2013-04-16 |
Medline Journal Info:
|
Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
|
Languages: eng Pagination: 1124-31 Citation Subset: IM |
Affiliation:
|
Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. eganbm@musc.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
African Americans
/
statistics & numerical data Antihypertensive Agents / therapeutic use* Blood Pressure / drug effects* Drug Therapy / methods, statistics & numerical data Drug Therapy, Combination European Continental Ancestry Group / statistics & numerical data Female Humans Hypertension / drug therapy*, ethnology, physiopathology Male Middle Aged Multivariate Analysis Outcome Assessment (Health Care) / methods, statistics & numerical data Proportional Hazards Models Retrospective Studies Time Factors |
| Grant Support | |
ID/Acronym/Agency:
|
1UL1RR029882/RR/NCRR NIH HHS; DK067615/DK/NIDDK NIH HHS; HL091841/HL/NHLBI NIH HHS; HL105880/HL/NHLBI NIH HHS; P20 RR-017696/RR/NCRR NIH HHS; UL1 RR029882/RR/NCRR NIH HHS; UL1 TR000062/TR/NCATS NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Genomic association analysis identifies multiple loci influencing antihypertensive response to an an...
Next Document: Testosterone Induces Vascular Smooth Muscle Cell Migration by NADPH Oxidase and c-Src-Dependent Path...