Document Detail


Trends in medication choices for hypertension in the elderly. The decline of the thiazides.
MedLine Citation:
PMID:  7737714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied the evolution in choice of antihypertensive therapy in the elderly over a seven-year period and defined factors associated with such prescribing. To accomplish this, we performed a retrospective analysis of 8428 enrollees older than 65 years of age in the New Jersey Medicaid and Medicare programs newly begun on antihypertensive therapy between 1982 and 1988. Diuretics were the most common agents prescribed (51%), followed by calcium channel blockers (14%), beta-blockers (13%), central adrenergic antagonists (11%), and angiotensin-converting enzyme inhibitors (5%). However, the use of diuretics declined sharply during the latter part of the time interval studied. Using logistic regression modeling, we determined that the odds of a subject being started on a diuretic compared with any other antihypertensive drug decreased from 1.0 during the referent years 1982 to 1984 to 0.75 in 1985 to 1986 and to 0.41 in 1987 to 1988, after controlling for demographics, comorbidity, and hospital and physician visits (P < .001). The relative odds of diuretic use were significantly increased (P < .05) for the oldest subjects (odds ratio, 1.28 for age 85 and older versus ages 65 to 74 odds), women (odds ratio, 1.15), and blacks (odds ratio, 1.14). Despite the growing evidence during the study interval of the efficacy of diuretics in treating hypertension in the elderly, diuretic use diminished throughout this period in relation to other antihypertensive drugs. Subject characteristics (oldest subjects, women, and blacks) were important determinants of physicians' choice of antihypertensive therapy.
Authors:
M Monane; R J Glynn; J H Gurwitz; R L Bohn; R Levin; J Avorn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Hypertension     Volume:  25     ISSN:  0194-911X     ISO Abbreviation:  Hypertension     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-06-06     Completed Date:  1995-06-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1045-51     Citation Subset:  IM    
Affiliation:
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antihypertensive Agents / therapeutic use*
Benzothiadiazines*
Diuretics
Female
Humans
Hypertension / drug therapy*
Retrospective Studies
Sodium Chloride Symporter Inhibitors / therapeutic use*
Grant Support
ID/Acronym/Agency:
AG 08812/AG/NIA NIH HHS; K08 AG00510/AG/NIA NIH HHS; K08 AG00642/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Benzothiadiazines; 0/Diuretics; 0/Sodium Chloride Symporter Inhibitors
Comments/Corrections
Comment In:
Hypertension. 1995 May;25(5):1052   [PMID:  7737715 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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