EFFICACY OF ANTIHYPERTENSIVE DRUG TREATMENT ACCORDING TO AGE, SEX, BLOOD PRESSURE, AND PREVIOUS CARDIOVASCULAR DISEASE IN PATIENTS OVER THE AGE OF 60

The Lancet ◽  
1986 ◽  
Vol 328 (8507) ◽  
pp. 589-592 ◽  
Author(s):  
A. Amery ◽  
R. Brixko ◽  
D. Clement ◽  
A. De Schaepdryver ◽  
R. Fagard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Drug Treatment ◽  
Antihypertensive Drug ◽  
Antihypertensive Drug Treatment

scholarly journals Cost-Effectiveness of Initiating Pharmacological Treatment in Stage One Hypertension Based on 10-Year Cardiovascular Disease Risk

Hypertension ◽  
2020 ◽  
Author(s):  
Margaret Constanti ◽  
Christopher N. Floyd ◽  
Mark Glover ◽  
Rebecca Boffa ◽  
Anthony S. Wierzbicki ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cost Effectiveness ◽  
Drug Treatment ◽  
Antihypertensive Drug ◽  
Cost Effective ◽  
Base Case ◽  
Cvd Risk ◽  
Antihypertensive Drug Treatment ◽  
Stage 1 ◽  
Quality Adjusted Life

Antihypertensive drug treatment is cost-effective for adults at high risk of developing cardiovascular disease (CVD). However, the cost-effectiveness in people with stage 1 hypertension (140–159 mm Hg systolic blood pressure) at lower CVD risk remains unclear. The objective was to establish the 10-year CVD risk threshold where initiating antihypertensive drug treatment for primary prevention in adults, with stage 1 hypertension, becomes cost-effective. A lifetime horizon Markov model compared antihypertensive drug versus no treatment, using a UK National Health Service perspective. Analyses were conducted for groups ranging between 5% and 20% 10-year CVD risk. Health states included no CVD event, CVD and non-CVD death, and 6 nonfatal CVD morbidities. Interventions were compared using cost-per-quality-adjusted life-years. The base-case age was 60, with analyses repeated between ages 40 and 75. The model was run separately for men and women, and threshold CVD risk assessed against the minimum plausible risk for each group. Treatment was cost-effective at 10% CVD risk for both sexes (incremental cost-effectiveness ratio £10 017/quality-adjusted life-year [$14 542] men, £8635/QALY [$12 536] women) in the base-case. The result was robust in probabilistic and deterministic sensitivity analyses but was sensitive to treatment effects. Treatment was cost-effective for men regardless of age and women aged >60. Initiating treatment in stage 1 hypertension for people aged 60 is cost-effective regardless of 10-year CVD risk. For other age groups, it is also cost-effective to treat regardless of risk, except in younger women.

P1949Changes in prevalence patients with arterial hypertension in Russia

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Badin ◽  
I V Fomin ◽  
D S Polyakov ◽  
S S Yakushin ◽  
E A Smirnova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Treatment ◽  
Arterial Hypertension ◽  
Antihypertensive Drug ◽  
P Value ◽  
Antihypertensive Drug Treatment ◽  
European Guidelines ◽  
The Mean ◽  
Grade 3

Abstract Aim The present study shows the dynamics of the prevalence different grades of AH and treatment coverage over15 years of observation. Methods 8740 apartments were randomized in 2002 year in eight regions of Russia and 19449 individuals were included. Re-examination was carried out in 2017 year. The representative sample was separated in four groups: Grade 0 – individuals with systolic blood pressure (BP) <140 mm Hg and diastolic blood pressure <90 mm Hg; and three Grades of arterial hypertension (AH) in accordance with European guidelines. Also, we select patient with and without antihypertensive drug treatment (AHDT). Results The mean age individuals was 44.4±19.3 years in 2002 year. Grade 0 had 63.3% participants (mean age 36.5±17.1 y.), Grade 1 – 19.5% (mean age 55.2±15.4 y.), Grade 2 – 11.7% (mean age 60.6±13.5 y.) and Grade 3 – 5.6% (mean age 62.4±12.8 y.). 3.0% participants had AHDT and blood pressure meets Grade 0. Patients with AH Grade 1 used drugs in 25.5% cases, with Grade 2 – 49.4% and with Grade 3 – 60.8% patients respectively. The mean age of participants with AHTD was significantly higher than mean age group without AHTD in Grade 0, 1 and 2 (p<0.001). In group Grade 3 mean age was not difference (p=0.16). The mean age individuals (51.3±16.9 y.) in 2017 year was significantly higher on 6.9 years than mean age in 2002 year (p<0.001). The proportion of patients with AHDT in all grades groups in sample 2017 year were significantly higher than in sample 2002 year (Table). The prevalence of AH in 2002 y. amounted to 38.6%. In 2017 y. prevalence of AH was significantly higher – 41.4% (p<0.001). Structure of samples Grade 2002 2017 AHDT Mean age AHDT P value Mean age 0 63,3% No 35,8±16,8 70,1% 42,6±13,9 Yes 3,0% 57,4±14,5 16,3% <0,001 63,6±12,0 1 19,5% No 53,3±15,7 23,6% 57,3±13,3 Yes 25,5% 60,9±13,0 68,4% <0,001 66,3±11,3 2 11,7% No 58,5±14,2 5,4% 58,0±14,9 Yes 49,4% 62,7±12,3 80,6% <0,001 66,5±11,5 3 5,6% No 61,7±13,9 1,0% 63,6±17,6 Yes 60,8% 62,8±12,0 71,1% 0,03 66,0±12,8 ALL 100% 44,4±19,3 100% 51,3±16,9 AHDT: antihypertensive drug treatment. Conclusion Over 15 years follow up period the prevalence of hypertension in Russia increased to 41.4%, but the effectiveness of therapy remains low.

scholarly journals Management of renin-angiotensin-aldosterone inhibitors and other antihypertensives and their clinical effects on pre-anesthesia blood pressure

2022 ◽  
Author(s):  
Eda Balcı ◽  
Zeliha Aslı Demir ◽  
Melike Bahçecitapar
Keyword(s):  
Blood Pressure ◽  
Drug Treatment ◽  
Systolic Blood Pressure ◽  
Antihypertensive Drug ◽  
Antihypertensive Drugs ◽  
Treatment Strategies ◽  
Clinical Effects ◽  
Renin Angiotensin ◽  
Perioperative Morbidity ◽  
Antihypertensive Drug Treatment

Background: Blood pressure fluctuations appear more significant in patients with poorly controlled hypertension and are known to be associated with adverse perioperative morbidity. In the present study, we aimed to determine the effects of antihypertensive drug treatment strategies on preanesthetic operating room blood pressure measurements.Methods: A total of 717 patients participated in our study; 383 patients who were normotensive based on baseline measurements and not under antihypertensive therapy were excluded from the analysis. The remaining 334 patients were divided into six groups according to the antihypertensive drug treatment. These six groups were examined in terms of preoperative baseline and pre-anesthesia blood pressure measurements. Results: As a result of the study, it was observed that 24% of patients had high blood pressure precluding surgery, and patients using renin-angiotensin-aldosterone system inhibitors (RAASI) had higher pre-anesthesia systolic blood pressure than patients using other antihypertensive drugs. Patients who received beta-blockers were also observed to have the lowest pre-anesthesia systolic blood pressure, diastolic blood pressure, and mean blood pressure, compared to others. Conclusions: Recently, whether RAASI should be continued preoperatively remains controversial. Our study shows that RAASI cannot provide optimal pre-anesthesia blood pressure and lead to an increase in the number of postponed surgeries, probably due to withdrawal of medication before the operation. Therefore, the preoperative discontinuation of RAASI should be reevaluated in future studies.

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