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Titolo:
THE ASSOCIATION OF ANTIHYPERTENSIVE MEDICATION WITH SERUM CREATININE CHANGES IN OLDER ADULTS
Autore:
SMITH NL; PSATY BM; HECKBERT SR; LEMAITRE RN; KATES DM; RUTAN GH; BLEYER A;
Indirizzi:
UNIV WASHINGTON,DEPT EPIDEMIOL,CARDIOVASC HLTH RES UNIT,METROPOLITAN PK,EAST TOWER,SUITE 1360 SEATTLE WA 98101 UNIV WASHINGTON,DEPT MED SEATTLE WA 98195 UNIV WASHINGTON,DEPT HLTH SERV SEATTLE WA 98195 SEATTLE VET AFFAIRS MED CTR SEATTLE WA 00000 NASHVILLE VET AFFAIRS MED CTR NASHVILLE TN 00000 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT MED WINSTON SALEM NC 27103
Titolo Testata:
American journal of hypertension
fascicolo: 12, volume: 10, anno: 1997,
parte:, 1
pagine: 1368 - 1377
SICI:
0895-7061(1997)10:12<1368:TAOAMW>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
TREATED ESSENTIAL-HYPERTENSION; BLOOD-PRESSURE; RENAL-FUNCTION; UNITED-STATES; DISEASE; TRIAL; INSUFFICIENCY; PROGRESSION; HEALTH; RISK;
Keywords:
HYPERTENSION; TREATMENT; CREATININE; ELDERLY; COHORT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
N.L. Smith et al., "THE ASSOCIATION OF ANTIHYPERTENSIVE MEDICATION WITH SERUM CREATININE CHANGES IN OLDER ADULTS", American journal of hypertension, 10(12), 1997, pp. 1368-1377

Abstract

Many of the potential effects of antihypertensive therapy, including renal function, have been inadequately investigated in clinical trialsin older adults.In an observational study, we examined the association between treatment with various classes of antihypertensive agents and 3-year changes in serum creatinine in 1296 older adults with treatedhypertension and without prior renal disease (mean age 72.2 years; 60% female; 30% diabetic; 42% with cardiovascular disease (CVD)) from the Cardiovascular Health Study. Baseline antihypertensive medications included thiazides (HCT), beta-adrenergic blockers, angiotensin converting enzyme inhibitors (ACE-I), calcium channel blockers (CCB), vasodilators (VAS), HCT + BE, HCT + ACE-I, HCT + CCB, HCT + VAS, loop diuretics (LOOP), and other combinations. Unadjusted results indicated that minimal changes in mean serum creatinine occurred over time for all therapies and only a few changes were statistically significant (HCT: +0.02 mg/dL, ACE-I: +0.04, CCB: +0.04; all P < .05; LOOP: +0.06 mg/dL; P < .001). In multivariate analyses with HCT users as the reference group and adjusting for baseline serum creatinine, age, sex, smoking, diabetes mellitus, CVD, height, weight, common carotid intima-media thickness, and use of allopurinol, phenytoin, cimetidine, and nonsteroidal antiinflammatory drugs, all of the relative changes were small and statistically nonsignificant except for HCT + VAS users (+0.07 mg/dL; P < .05). When users of the same therapy at baseline and follow-up were restricted, only LOOP users had significant albeit small changes in serum creatinine (+0.05 mg/dL; P < .05). Although results from clinical trials are needed to confirm these findings, these observational data suggest no major differences between specific antihypertensive therapiesin 3-year serum creatinine changes in older adults without prior renal disease. (C) 1997 American Journal of Hypertension, Ltd.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 08:15:11