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Titolo:
TEMPORAL PATTERNS OF ANTIHYPERTENSIVE MEDICATION USE AMONG OLDER ADULTS, 1989 THROUGH 1992 - AN EFFECT OF THE MAJOR CLINICAL-TRIALS ON CLINICAL-PRACTICE
Autore:
PSATY BM; KOEPSELL TD; YANEZ ND; SMITH NL; MANOLIO TA; HECKBERT SR; BORHANI NO; GARDIN JM; GOTTDIENER JS; RUTAN GH; SISCOVICK DS; FURBERG CD;
Indirizzi:
UNIV WASHINGTON,DEPT MED,CARDIOVASC HLTH RES UNIT,1730 MINOR AVE,SUITE 1360 SEATTLE WA 98101 UNIV WASHINGTON,DEPT EPIDEMIOL SEATTLE WA 98101 UNIV WASHINGTON,DEPT HLTH SERV SEATTLE WA 98101 UNIV WASHINGTON,DEPT BIOSTAT SEATTLE WA 98101 UNIV WASHINGTON,CTR CARDIOVASC HLTH STUDY COORDINATING SEATTLE WA 98101 NHLBI BETHESDA MD 20892 UNIV CALIF IRVINE,DIV CARDIOL IRVINE CA 92717 GEORGETOWN UNIV HOSP,DIV CARDIOL WASHINGTON DC 20007 VET ADM MED CTR MEMPHIS TN 38104 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT PUBL HLTH SCI WINSTON SALEMNC 27103
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 18, volume: 273, anno: 1995,
pagine: 1436 - 1438
SICI:
0098-7484(1995)273:18<1436:TPOAMU>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIOVASCULAR HEALTH; HIP FRACTURE; HYPERTENSION; DISEASE; RISK;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
B.M. Psaty et al., "TEMPORAL PATTERNS OF ANTIHYPERTENSIVE MEDICATION USE AMONG OLDER ADULTS, 1989 THROUGH 1992 - AN EFFECT OF THE MAJOR CLINICAL-TRIALS ON CLINICAL-PRACTICE", JAMA, the journal of the American Medical Association, 273(18), 1995, pp. 1436-1438

Abstract

Objective.-To describe the changing patterns of antihypertensive medication use in the years immediately before and after the publication of the results of three major clinical trials of the treatment of hypertension in older adults. Design.-In this cohort study, adults 65 yearsor older were examined annually on four occasions between June 1989 and May 1992, and the use of antihypertensive medications was assessed by inventory at each visit. The four visits defined the boundaries of three study periods. For each study period, participants receiving antihypertensive therapy were either continuous users (n = 1667, 1643, and 1605, respectively) or starters (n = 157, 142, 120) of hypertensive therapy. The large clinical trials that convincingly proved the efficacy and safety of low-dose diuretic therapy in older adults were published during the latter parts of period 2 and the early parts of period 3. Results.-Among starters, the proportion initiating therapy on diuretics increased from 35.9% in period 2 to 47.5% in period 3, significantly so among women (P=.04). The proportions initiating other drugs displayed no significant trends. Among continuous users, the use of diuretics, beta-blockers, and vasodilators generally decreased over the 3-year period, while the use of calcium channel blockers and angiotensin-converting enzyme inhibitors increased significantly in each of the three periods (P<.05). The decline of 2.7% in the prevalence of diureticuse in period 1 abated during period 2 (1.8% decline), and it slowed significantly (P=.03) to almost a complete halt during period 3 (0.2% decline). The rate of increase in the use of calcium channel blockers slowed significantly (P=.01) between period 1 (+6.7%) and period 3 (+2.8%). Conclusions.-Although other factors such as cost may have been important, the temporal trends in antihypertensive drug therapy coincided in time with and may have reflected in part the influence of the major clinical trials on the patterns of clinical practice.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 13:34:57