Trends in Antihypertensive Medication Use Among US Patients With Resistant Hypertension, 2008 to 2014

Hwang, Andrew Y.; Dave, Chintan V.; Smith, Steven M.

doi:10.1161/hypertensionaha.116.08128

Cited by 45 publications

(32 citation statements)

References 31 publications

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“…The changing approach and therapeutic options are further clarified in the most recent guidelines [10]. However, many patients still receive beta-blockers or continue therapy from historical prescriptions [28]. Our analysis confirms that beta-blockers are inferior to other agents (most notably CCB and RAS antagonists), particularly in preventing strokes.…”

Section: Hypertensionsupporting

confidence: 54%

Beta-blocker efficacy across different cardiovascular indications: an umbrella review and meta-analytic assessment

Ziff

Samra

Howard

et al. 2020

BMC Med

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Background: Beta-blockers are widely used for many cardiovascular conditions; however, their efficacy in contemporary clinical practice remains uncertain. Methods: We performed a prospectively designed, umbrella review of meta-analyses of randomised controlled trials (RCTs) investigating the evidence of beta-blockers in the contemporary management of coronary artery disease (CAD), heart failure (HF), patients undergoing surgery or hypertension (registration: PROSPERO CRD42016038375). We searched MEDLINE, EMBASE and the Cochrane Library from inception until December 2018. Outcomes were analysed as beta-blockers versus control for all-cause mortality, myocardial infarction (MI), incident HF or stroke. Two independent investigators abstracted the data, assessed the quality of the evidence and rated the certainty of evidence. Results: We identified 98 meta-analyses, including 284 unique RCTs and 1,617,523 patient-years of follow-up. In CAD, 12 meta-analyses (93 RCTs, 103,481 patients) showed that beta-blockers reduced mortality in analyses before routine reperfusion, but there was a lack of benefit in contemporary studies where ≥ 50% of patients received thrombolytics or intervention. Beta-blockers reduced incident MI at the expense of increased HF. In HF with reduced ejection fraction, 34 meta-analyses (66 RCTs, 35,383 patients) demonstrated a reduction in mortality and HF hospitalisation with beta-blockers in sinus rhythm, but not in atrial fibrillation. In patients undergoing surgery, 23 meta-analyses (89 RCTs, 19,211 patients) showed no effect of beta-blockers on mortality for cardiac surgery, but increased mortality in non-cardiac surgery. In non-cardiac surgery, beta-blockers reduced MI after surgery but increased the risk of stroke. In hypertension, 27 meta-analyses (36 RCTs, 260,549 patients) identified no benefit versus placebo, but beta-blockers were inferior to other agents for preventing mortality and stroke. Conclusions: Beta-blockers substantially reduce mortality in HF patients in sinus rhythm, but for other conditions, clinicians need to weigh up both benefit and potential risk.

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Section: Hypertensionsupporting

confidence: 54%

Beta-blocker efficacy across different cardiovascular indications: an umbrella review and meta-analytic assessment

Ziff

Samra

Howard

et al. 2020

BMC Med

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“…Попередні дослідження показали, що з резис-тентною АГ пов'язане ожиріння [20], інші засвід-чили зв'язок з цукровим діабетом [25,33]. Також в дослідженнях виявлено, що РАГ пов'язана із збіль-шенням віку, жіночою статтю, негроїдною расою, наявністю цукрового діабету, ожирінням, хроніч-ним захворюванням нирок і гіпертрофією лівого шлуночка (ЛШ) [17-19, 21, 26, 29].…”

Section: вступunclassified

Структура Пацієнтів Із Резистентною Артеріальною Гіпертензією

Rekovets

Torbas

Kushnir

et al. 2021

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(155,0 ± 44,0 нг/л проти 35,9 ± 20,8 нг/л), вищий індекс маси міокарда лівого шлуночка (147,50 ± 3,46 г/м 2 проти 135,30 ± 1,74 г/м 2 ), частіше спостерігались ожиріння (42,9 проти 37,5 %), аномалії розвитку нирок (2,7 проти 0,8 %), облітеруючий атеросклероз нижніх кінцівок (2,0 проти 0,2 %), структурні зміни наднирників (3,0 проти 1,2 %), нефропатія (1,3 проти 0,2 %), вищий ступінь серцевої недостатності (СН 2А стадії; 16,9 проти 8,5 %). Ступінь зниження офісного АТ серед пацієнтів, які приймали 3 антигіпертензивні препарати та більше, загалом становив для САТ 43,47 ± ± 0,65 мм рт.ст., для ДАТ -20,33 ± 0,74 мм рт.ст., р < 0,001

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“…A detailed description of the development of the incident TRH cohort has been previously published. 11 Briefly, the incident TRH cohort was derived from all patients with treated hypertension, including patients with incident hypertension during the study period and patients with prevalent treated hypertension at study entry. Patients with incident TRH were required to have at least 60 days of overlapping use of ≥4 antihypertensive drugs, and each antihypertensive drug was required to have been filled at least twice.…”

Section: Study Design and Data Sourcesmentioning

confidence: 99%

Use of Prescription Medications That Potentially Interfere With Blood Pressure Control in New-Onset Hypertension and Treatment-Resistant Hypertension

Hwang

Smith

2018

American Journal of Hypertension

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Trends in Antihypertensive Medication Use Among US Patients With Resistant Hypertension, 2008 to 2014

Abstract: Abstract-Little is known of US trends in antihypertensive drug use for patients with treatment-resistant hypertension (TRH).We analyzed antihypertensive use among patients with TRH (treated with ≥4 antihypertensive drugs concurrently)

Cited by 45 publications

References 31 publications

Beta-blocker efficacy across different cardiovascular indications: an umbrella review and meta-analytic assessment

Beta-blocker efficacy across different cardiovascular indications: an umbrella review and meta-analytic assessment

Структура Пацієнтів Із Резистентною Артеріальною Гіпертензією

Use of Prescription Medications That Potentially Interfere With Blood Pressure Control in New-Onset Hypertension and Treatment-Resistant Hypertension

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