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Titolo:
TEMPORAL PATTERNS OF ANTIHYPERTENSIVE MEDICATION USE AMONG ELDERLY PATIENTS - THE CARDIOVASCULAR HEALTH STUDY
Autore:
PSATY BM; SAVAGE PJ; TELL GS; POLAK JF; HIRSCH CH; GARDIN JM; MCDONALD RH;
Indirizzi:
CARDIOVASC HLTH STUDY,CTR COORDINATING,CENTURY SQ,SUITE 2025,1501 4THAVE SEATTLE WA 98101 UNIV WASHINGTON,DEPT MED SEATTLE WA 98195 UNIV WASHINGTON,DEPT EPIDEMIOL SEATTLE WA 98195 UNIV PITTSBURGH,DEPT EPIDEMIOL PITTSBURGH PA 15260 UNIV WASHINGTON,DEPT HLTH SERV SEATTLE WA 98195 NHLBI,DIV EPIDEMIOL & CLIN APPLICAT,EPIDEMIOL & BIOMETRY PROGRAM BETHESDA MD 20892 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PUBL HLTH SCI WINSTON SALEMNC 27103 BRIGHAM & WOMENS HOSP,DEPT RADIOL BOSTON MA 02115 UNIV CALIF DAVIS,SACRAMENTO MED CTR,DEPT MED SACRAMENTO CA 95817 UNIV CALIF IRVINE,DEPT MED IRVINE CA 92717
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 15, volume: 270, anno: 1993,
pagine: 1837 - 1841
SICI:
0098-7484(1993)270:15<1837:TPOAMU>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOOD-PRESSURE; HYPERTENSION; EXPERIENCE; GLUCOSE; THERAPY; TRIAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
B.M. Psaty et al., "TEMPORAL PATTERNS OF ANTIHYPERTENSIVE MEDICATION USE AMONG ELDERLY PATIENTS - THE CARDIOVASCULAR HEALTH STUDY", JAMA, the journal of the American Medical Association, 270(15), 1993, pp. 1837-1841

Abstract

Objectives.-To estimate the incidence of newly treated hypertension and to describe the patterns of antihypertensive medication use among those aged 65 years and older. Design.-Medicare eligibility lists from four US communities (Forsyth County, North Carolina; Washington County, Maryland; Sacramento County, California; and Pittsburgh, Pa) were used to obtain a representative sample of 5201 community-dwelling elderly for the Cardiovascular Health Study, a prospective cohort study of risk factors for coronary heart disease and stroke. Participants were examined at baseline and again 1 year later. The two examinations included standardized questionnaires, blood pressure measurements, and the assessment of medication use by medication inventory. In this cohort analysis, we excluded 231 subjects (4.4%) who did not return for follow-up, 69 (1.3%) who had missing data for medications, and another 495 (9.5%) who were taking ''antihypertensive'' medications for an indication other than high blood pressure. Interventions.-None. Results.-Amongthe 4406 participants, 1613 used antihypertensive medications at bothvisits. Between the two visits, 144 started and 115 stopped antihypertensive therapy. Among nonusers at baseline, the annual incidence of newly treated hypertension was 5.2% in women and 5.6% in men. Due to the number of participants who stopped therapy, the overall prevalence of antihypertensive treatment increased only slightly, from 40.7% to 41.1% in women and from 37.1% to 38.2% in men, during 1 year of follow-up. After adjustment for age, systolic blood pressure, number of antihypertensive drugs, diabetes, and cardiovascular disease, the newly treated hypertensives were about half as likely as the previously treated hypertensives to receive diuretics (odds ratio [OR], 0.59; P=.008) or beta-blockers (OR, 0.52; P=.01); and they were about twice as likely to receive calcium channel blockers (OR, 1.88; P<.004) or angiotensin converting enzyme inhibitors (OR, 2.40; P<.001). A similar pattern of within-person changes over time was apparent among the continuous users. Conclusions.-Between June 1990 and June 1991, physicians were increasingly prescribing angiotensin converting enzyme inhibitors and calcium channel blockers in place of diuretics and beta-blockers for the treatment of hypertension in elderly patients, especially for those just starting therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 12:42:28