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Titolo:
RESPONSE TO A 2ND SINGLE ANTIHYPERTENSIVE AGENT USED AS MONOTHERAPY FOR HYPERTENSION AFTER FAILURE OF THE INITIAL-DRUG
Autore:
MATERSON BJ; REDA DJ; PRESTON RA; CUSHMAN WC; MASSIE BM; FREIS ED; KOCHAR MS; HAMBURGER RJ; FYE C; LAKSHMAN R; GOTTDIENER J; RAMIREZ EA; HENDERSON WG;
Indirizzi:
VET AFFAIRS MED CTR,1201 NW 16TH ST MIAMI FL 33125 DEPT VET AFFAIRS,MED RES SERV,COOPERAT STUDIES PROGRAM WASHINGTON DC 00000
Titolo Testata:
Archives of internal medicine
fascicolo: 16, volume: 155, anno: 1995,
pagine: 1757 - 1762
SICI:
0003-9926(1995)155:16<1757:RTA2SA>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEQUENTIAL MONOTHERAPY; PATIENT; COMBINATIONS; THERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
16
Recensione:
Indirizzi per estratti:
Citazione:
B.J. Materson et al., "RESPONSE TO A 2ND SINGLE ANTIHYPERTENSIVE AGENT USED AS MONOTHERAPY FOR HYPERTENSION AFTER FAILURE OF THE INITIAL-DRUG", Archives of internal medicine, 155(16), 1995, pp. 1757-1762

Abstract

Background: An important issue in clinical practice is how to treat patients whose blood pressure does not respond to the first antihypertensive drug selected. Objective: To analyze the antihypertensive response of patients who had failed to achieve their diastolic blood pressure goal (< 90 mm Hg at the end of 8 to 12 weeks of titration) with one,of six randomly allocated drugs or placebo to the random allocation ofan alternate drug. Methods: We initially randomized 1292 men with diastolic blood pressure of 95 to 109 mm Hg to treatment with hydrochlorothiazide, atenolol, captopril, clonidine hydrochloride, diltiazem hydrochloride (sustained release), prazosin hydrochloride, or placebo. Of 410 men in whom initial treatment failed, 352 qualified for randomization to the alternate drug. Results: Of the 352 patients, 173 (49.1%) achieved their goal diastolic blood pressure, in 133 (37.8%) the alternate drug failed, and 46 (13.1%) left the study for various reasons. Overall response rates were as follows: diltiazem, 63%; clonidine, 59%; prazosin, 47%; hydrochlorothiazide, 46%; atenolol, 41%, and captopril,37%. The best response rate for patients in whom hydrochlorothiazide failed was achieved with diltiazem (70%); after atenolol failure, clonidine (86%);after captopril failure, prazosin (54%); after clonidine failure, diltiazem (100%), after diltiazem failure, captopril (67%); and after prazosin failure, clonidine (53%). The combined response rate for patients initially randomized to an active treatment was 76.0%, which is similar to that achieved by the combination of two drugs in previous studies. Conclusions: We conclude that sequential single-drug therapy is a rational approach for treatment of hypertension in patientsin whom initial drug therapy has failed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 05:56:31