A combined effect of sleep quality and sleep medication use on the risk of falls suggests that medication effectiveness may be an important factor to consider in understanding the risk of falls associated with sedative medications.
Profile monitoring is one of the methods used in statistical process control (SPC) to understand the functional relationship between response and explanatory variables by tracking this relationship and estimating parameters. SPC is done in two phases: In Phase I, a statistical model is created and its parameters estimated using historical data. Phase II implements the statistical model and monitors the live ongoing process. Control charts are graphical tools used to monitor these functional relationships over time in both Phase I and Phase II. This study provides a step‐by‐step application for parametric, nonparametric, and semiparametric methods in profile monitoring and creates an in‐depth guideline with comparative analysis studies for novice practitioners. A comparative analysis under each distributional assumption is conducted for various control charts.
Objective
Metabolic syndrome (MetS) is associated with cardiovascular disease (CVD). Insulin resistance has been hypothesized as the underlying feature of MetS. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are widely used antihypertensives that may improve insulin sensitivity. The aim of the study is to evaluate the effect of ACEI/ARB on incident CVD events in older hypertensive patients with MetS.
Materials/Methods
We used the Cardiovascular Health Study, a prospective cohort study of individuals > 65 years of age to evaluate ACEI/ARB use and time to CVD events (including coronary and cerebrovascular events). The study included 777 subjects who had hypertension and ATP III-defined MetS, but free of CVD and diabetes at baseline. Cox regression models were used to evaluate the effect of ACEI/ARB as compared to other antihypertensives on the time to the first CVD events.
Results
ACEI/ARB use was associated with a decreased risk of CVD events (adjusted HR=0.658, 95 % C.I. [0.436-0.993]) compared to other antihypertensives. When CVD endpoints were evaluated separately, use of ACEI/ARB was associated with lower rates of angioplasty and coronary events (HR of 0.129 and 0.530 respectively, with 95 % CI [0.017-0.952] and [0.321-0.875]).
Conclusions
ACEI/ARB use was associated with a lower risk of CVD events in older hypertensive patients with MetS, primarily due to a reduction in coronary events. The potential protective effect of ACEI/ARB on CVD events in older individuals with MetS will need further confirmation from prospective studies.
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