Sex differences in antihypertensive drug use and blood pressure control

2019 ◽  
Vol 95 (1124) ◽  
pp. 295-299
Author(s):  
Junwen Wang ◽  
Weihong Jiang ◽  
Manju Sharma ◽  
Yuyan Wu ◽  
Jiayin Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sex Differences ◽  
Drug Use ◽  
Antihypertensive Drug ◽  
Antihypertensive Drugs ◽  
Age Groups ◽  
Channel Blockers ◽  
Elderly Age ◽  
Converting Enzyme Inhibitors ◽  
Males And Females

BackgroundHypertension is the most important modifiable cardiovascular risk factor. Epidemiological studies have shown the benefits of lowering blood pressure (BP), but BP control is a major challenge. Furthermore, there are significant sex differences in antihypertensive drug use and BP control. This study examined sex differences in antihypertensive drug use and BP control, with the aim of reducing the complications of hypertension and improving quality of life.MethodsThe study was performed in our outpatient hypertension clinic, and included 1529 patients without secondary hypertension or comorbidities. The study, investigated BP control rates and patterns of antihypertensive drug use in male and female. All data were collected using structured questionnaires and patient measurements.ResultsThe study included 713 males and 816 females in this study. Fewer females had hypertension in the younger age group (16.2% vs 11.6%; p>0.05), but this difference disappeared in middle-aged (47.8% vs 49.9 %; p<0.05) and elderly age groups (36.0% vs 38.5%; p<0.05). BP control rates differed between males and females (35.6% in male, 31.9% in female, p<0.01). There was an overall difference in BP control rates between males and females (35.6% in males, 31.9% in females, p<0.01). In this aged 18–44 years, angiotensin converting enzyme inhibitors (ACEIs) showed the best control rate in males, while calcium channel blockers (CCBs) were least effective (61.5% with ACEIs, 28.6% with CCBs; p<0.05). In this aged 45–64 years, diuretics (DUs) showed the best control rate in females, while CCBs were least effective (47.5% with DUs, 28.3% with CCBs; p<0.05).ConclusionsSex plays an important role in BP control. In those aged 18–44 years, males using ACEIs showed best control rates. In those aged 45–64 years, females using DUs showed best control rates. Our study provides a basis with the selection of antihypertensive drugs according to sex and age.

scholarly journals Awareness, Treatment, and Control Rates of Hypertension in Adults Aged 35–75 Years in Three Provinces of Central China

2020 ◽  
Vol 33 (5) ◽  
pp. 471-471
Author(s):  
Jia-li Song ◽  
Jing-wei Yang ◽  
Dan-wei Zhang ◽  
Jian-lan Cui ◽  
Chao-qun Wu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Use ◽  
Antihypertensive Drug ◽  
Mixed Model ◽  
Family Income ◽  
Antihypertensive Drugs ◽  
Individual Characteristics ◽  
Central China ◽  
Combination Drug ◽  
And Control

Abstract Background To describe the status of hypertension awareness, treatment, and control rates and their relationships with individual characteristics in Henan, Hubei, and Hunan provinces in central China, and to describe the patterns of antihypertensive drug use in this region. Methods The awareness, treatment, and control rates of hypertension in this area were identified through analysis of the data from China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project in three provinces (Henan, Hubei, and Hunan) of central China. The patterns of antihypertensive drug use were also examined. The mixed model was used to analyze the relationship between the awareness, treatment, and control rates and individual characteristics at the patient level. Results A total of 268,461 subjects were enrolled with 37.9% male and an average age of (56.3 ± 9.7) years. Among them, 129,099 (48.1%) had hypertension, of which 49.5% were aware of hypertension, 42.9% received antihypertensive drugs, and 11.5% had blood pressure under control. Calcium channel antagonists (54.6%) were the most widely used among all antihypertensive drugs. Of the patients whose blood pressure were not controlled, 25,482 patients (86.4%) took only one antihypertensive drug. In addition, the rate of awareness, treatment, and control of hypertension varied significantly among different populations: the rates were higher among the older, as well as among subjects with higher annual family income, higher educational status, and history of myocardial infarction, stroke, and diabetes (all P &lt; 0.05). Conclusions The awareness, treatment, and control rates of hypertension in adult patients of central China require further improvement. Meanwhile the proportion of combination drug therapy is low.

scholarly journals A Retrospective Longitudinal Cohort Study of Antihypertensive Drug Use and New-Onset Diabetes in Taiwanese Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ching-Ya Huang ◽  
Tsochiang Ma ◽  
Liyun Tien ◽  
Yow-Wen Hsieh ◽  
Shwu-Yi Lee ◽  
...  
Keyword(s):  
Drug Use ◽  
Antihypertensive Drug ◽  
Antihypertensive Drugs ◽  
Reference Group ◽  
Clinical Information ◽  
Channel Blockers ◽  
Thiazide Diuretics ◽  
Hypertensive Patients ◽  
Onset Diabetes ◽  
New Onset

Antihypertensive drugs have been linked to new-onset diabetes (NOD); however, data on the effect of these drugs on the development of NOD in hypertensive patients has not been well determined in a clinical setting. The aim was to investigate the association between antihypertensive drugs and NOD in Taiwan. We conducted a retrospective study of hypertensive Taiwanese patients receiving antihypertensive drugs treatment between January 2006 and December 2011. Clinical information and laboratory parameters were collected by reviewing the medical records. We estimated the odds ratios (ORs) of NOD associated with antihypertensive drug use; nondiabetic subjects served as the reference group. A total of 120 NOD cases were identified in 1001 hypertensive patients during the study period. The risk of NOD after adjusting sex, age, baseline characteristics, and lipid profiles was higher among users of thiazide diuretics (OR, 1.65; 95% confidence interval (CI), 1.12–2.45) and nondihydropyridine (non-DHP) calcium channel blockers (CCBs) (OR, 1.96; 95% CI, 1.01–3.75) than among nonusers. Other antihypertensive drug classes were not associated with risk of NOD. Our results show that patients with hypertension who take thiazide diuretics and non-DHP CCBs are at higher risk of developing NOD than those who take other classes of antihypertensive drugs in Taiwan.

scholarly journals Antihypertensive drug exposure in premature infants from 1997 to 2013

2016 ◽  
Vol 27 (5) ◽  
pp. 905-911 ◽  
Author(s):  
Srikanth Ravisankar ◽  
Devon Kuehn ◽  
Reese H. Clark ◽  
Rachel G. Greenberg ◽  
P. Brian Smith ◽  
...  
Keyword(s):  
Birth Weight ◽  
Antihypertensive Drug ◽  
Premature Infants ◽  
Drug Exposure ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Systemic Hypertension ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

AbstractBackgroundSystemic hypertension is increasingly recognised in premature infants. There is limited evidence regarding treatment, and most published treatment recommendations are based solely on expert opinions.MethodsWe identified all infants born ⩽32 weeks of gestation and ⩽1500 g birth weight discharged from one of 348 neonatal ICUs managed by the Pediatrix Medical Group between 1997 and 2013. We defined antihypertensive drugs as vasodilators, angiotensin-converting enzyme inhibitors, β receptor blockers, calcium channel blockers, and central α2 receptor agonists. We compared characteristics between infants who were treated with at least one antihypertensive drug during their initial hospitalisation and infants who were not prescribed antihypertensive drugs using Wilcoxon’s ranked sum test or Pearson’s χ2-test.ResultsWe identified 2504/119,360 (2.1%) infants who required at least one antihypertensive drug. The median postnatal age of first exposure was 48 days (25th, 75th percentile 15, 86), and the median length of therapy was 6 days (1, 16). Hydralazine was the most commonly prescribed antihypertensive with 1280/2504 (51.1%) treated infants exposed to the drug. More than two antihypertensive drugs were administered in 582/2504 (23.2%) infants, and 199/2097 (9.5%) of the treated infants were discharged home on antihypertensive therapy. Infants who received antihypertensive drugs were of lower gestational age (p<0.001) and birth weight (p<0.001) compared with infants not prescribed antihypertensive drugs.ConclusionsOur study is the largest to describe current antihypertensive drug exposure in a cohort of exclusively premature infants born ⩽32 weeks of gestation. We found wide variations in practice for treating hypertension in premature infants.

scholarly journals The longitudinal association between the use of antihypertensive drugs and 24-hour sleep in nursing homes. Results from the randomized controlled COSMOS trial

2020 ◽  
Author(s):  
Elisabeth Flo-Groeneboom ◽  
Tony Elvegaard ◽  
Christine Gulla ◽  
Bettina Sandgate Husebo
Keyword(s):  
Blood Pressure ◽  
Nursing Home ◽  
Drug Use ◽  
Antihypertensive Drug ◽  
Sleep Problems ◽  
Antihypertensive Drugs ◽  
Control Group ◽  
Randomized Controlled ◽  
Nursing Home Patients ◽  
Longitudinal Association

Abstract BackgroundAntihypertensive drug use and sleep problems are highly prevalent in nursing home patients. While it is hypothesized that blood pressure and antihypertensive drug use can affect sleep, this has not been investigated in depth in this population. We aimed to investigate the longitudinal association between antihypertensive drug use, blood pressure and day- and night-time sleep over 4 months.MethodsThis study was based on secondary analyses from the multicomponent randomized controlled COSMOS trial, in which the acronym denotes the intervention: COmmuncation, Systematic pain assessment and treatment, Medication review, Organization of activities and Safety. We included baseline and 4-month follow-up data from a subgroup of nursing home patients who wore actigraphs (n = 107). The subgroup had different levels of blood pressure, from low (< 120) to high (≥ 141). Assessments included blood pressure, antihypertensive drug use, and sleep parameters as assessed by actigraphy.ResultsWe found a significant reduction in total sleep time at month four in the intervention group compared to the control group. When analyzing the control group alone, we found a significant association between antihypertensive use and increased daytime sleep. We also found negative associations between blood pressure, antihypertensive drug use and sleep onset latency in the control group.ConclusionOur results suggest a correlation between excessive daytime sleep and hypertensive drug use. These findings have clinical urgency, as antihypertensive drugs are frequently used in nursing homes, and sleep problems may be especially detrimental for this population.The trial is registered at clinicaltrials.gov (NCT02238652).

scholarly journals Antihypertensive Drugs and the Risk of Cancer: A Nationwide Cohort Study

2021 ◽  
Vol 10 (4) ◽  
pp. 771
Author(s):  
In-Jeong Cho ◽  
Jeong-Hun Shin ◽  
Mi-Hyang Jung ◽  
Chae Young Kang ◽  
Jinseub Hwang ◽  
...  
Keyword(s):  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Converting Enzyme Inhibitors ◽  
Incident Cancer ◽  
Increased Risk ◽  
Risk Of Cancer

We sought to assess the association between common antihypertensive drugs and the risk of incident cancer in treated hypertensive patients. Using the Korean National Health Insurance Service database, the risk of cancer incidence was analyzed in patients with hypertension who were initially free of cancer and used the following antihypertensive drug classes: Angiotensin-converting enzyme inhibitors (ACEIs); angiotensin receptor blockers (ARBs); beta blockers (BBs); calcium channel blockers (CCBs); and diuretics. During a median follow-up of 8.6 years, there were 4513 (6.4%) overall cancer incidences from an initial 70,549 individuals taking antihypertensive drugs. ARB use was associated with a decreased risk for overall cancer in a crude model (hazard ratio (HR): 0.744, 95% confidence interval (CI): 0.696–0.794) and a fully adjusted model (HR: 0.833, 95% CI: 0.775–0.896) compared with individuals not taking ARBs. Other antihypertensive drugs, including ACEIs, CCBs, BBs, and diuretics, did not show significant associations with incident cancer overall. The long-term use of ARBs was significantly associated with a reduced risk of incident cancer over time. The users of common antihypertensive medications were not associated with an increased risk of cancer overall compared to users of other classes of antihypertensive drugs. ARB use was independently associated with a decreased risk of cancer overall compared to other antihypertensive drugs.

scholarly journals Tianma Gouteng Yin as Adjunctive Treatment for Essential Hypertension: A Systematic Review of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-18 ◽  
Author(s):  
Jie Wang ◽  
Bo Feng ◽  
Xiaochen Yang ◽  
Wei Liu ◽  
Yongmei Liu ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Randomized Clinical Trials ◽  
Enzyme Inhibitors ◽  
Antihypertensive Drugs ◽  
Data Extraction ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Deficiency Syndrome ◽  
Adjunctive Treatment ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

Background. Tianma Gouteng Yin (TGY) is widely used for essential hypertension (EH) as adjunctive treatment. Many randomized clinical trials (RCTs) of TGY for EH have been published. However, it has not been evaluated to justify their clinical use and recommendation based on TCM zheng classification.Objectives. To assess the current clinical evidence of TGY as adjunctive treatment for EH with liver yang hyperactivity syndrome (LYHS) and liver-kidney yin deficiency syndrome (LKYDS).Search Strategy. 7 electronic databases were searched until November 20, 2012.Inclusion Criteria. RCTs testing TGY combined with antihypertensive drugs versus antihypertensive drugs were included.Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.Results. 22 RCTs were included. Methodological quality was generally low. Except diuretics treatment group, blood pressure was improved in the other 5 subgroups; zheng was improved in angiotensin converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), and “CCB + ACEI” treatment groups. The safety of TGY is still uncertain.Conclusions. No confirmed conclusion about the effectiveness and safety of TGY as adjunctive treatment for EH with LYHS and LKYDS could be made. More rigorous trials are needed to confirm the results.

Antihypertensive Drugs and Diabetic Retinopathy in Patients with Type 2 Diabetes

2015 ◽  
Vol 235 (2) ◽  
pp. 87-96
Author(s):  
Jen-Chieh Lin ◽  
Mei-Shu Lai
Keyword(s):  
Diabetic Retinopathy ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Incidence Rates ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Type 2 Diabetic Patients ◽  
Converting Enzyme Inhibitors ◽  
Type 2 Diabetic

Objective: To evaluate the association between the development of sight-threatening diabetic retinopathy (STDR) and antihypertensive drugs (AHDs) use among type 2 diabetic patients with concomitant hypertension. Methods: Type 2 diabetic patients aged 20-100 years who had at least one prescription for AHDs between 2000 and 2011 were identified from the Longitudinal Health Insurance Database (LHID) 2005. The incidence rates of STDR were followed and Cox proportional hazard models were used to analyze the risk associated with AHDs. Results: Users of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) were associated with a significantly higher risk than users of calcium channel blockers (CCBs), independent of baseline characteristics. After adjusting for time-varying use of concomitant medications for propensity score-matched or -unmatched cohorts, the results showed that patients receiving ACEIs/ARBs and CCBs were associated with a significantly greater risk compared with β-blocker users. Conclusions: Our study did not support a superiority of ACEIs/ARBs and CCBs over β-blockers for lowering the progression of diabetic retinopathy.

scholarly journals Control of blood pressure and cardiovascular outcomes in type 2 diabetes

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 304-323 ◽  
Author(s):  
Hernando Vargas-Uricoechea ◽  
Manuel Felipe Cáceres-Acosta
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Events ◽  
Angiotensin Receptor Blockers ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors ◽  
Patients With Diabetes ◽  
The Impact

AbstractHigh blood pressure in patients with diabetes mellitus results in a significant increase in the risk of cardiovascular events and mortality. The current evidence regarding the impact of intervention on blood pressure levels (in accordance with a specific threshold) is not particularly robust. Blood pressure control is more difficult to achieve in patients with diabetes than in non-diabetic patients, and requires using combination therapy in most patients. Different management guidelines recommend initiating pharmacological therapy with values >140/90 mm/Hg; however, an optimal cut point for this population has not been established. Based on the available evidence, it appears that blood pressure targets will probably have to be lower than <140/90mmHg, and that values approaching 130/80mmHg should be recommended. Initial treatment of hypertension in diabetes should include drug classes demonstrated to reduce cardiovascular events; i.e., angiotensin converting-enzyme inhibitors, angiotensin receptor blockers, diuretics, or dihydropyridine calcium channel blockers. The start of therapy must be individualized in accordance with the patient's baseline characteristics, and factors such as associated comorbidities, race, and age, inter alia.

scholarly journals A Japan nationwide web-based survey of patient preference for renal denervation for hypertension treatment

2021 ◽  
Author(s):  
Kazuomi Kario ◽  
Hideaki Kagitani ◽  
Shoko Hayashi ◽  
Satsuki Hanamura ◽  
Keisuke Ozawa ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Drug Therapy ◽  
Side Effects ◽  
Antihypertensive Drug ◽  
Patient Preference ◽  
Renal Denervation ◽  
Antihypertensive Drugs ◽  
Japanese Patients ◽  
Home Blood Pressure ◽  
Antihypertensive Drug Therapy

AbstractRenal denervation is a potential alternative to antihypertensive drug therapy. However, data on patient preference for this treatment option are limited and there are no data specifically from Asian patients. This study evaluated patient preference for renal denervation in patients with hypertension from Japan. Patients were a subset of those who participated in a March 2020 online electronic survey of patients with hypertension who had regularly visited medical institutions for treatment, were receiving antihypertensive drug therapy and had home blood pressure recordings available. The survey included a question about patient preference for treatment with renal denervation. A total of 2,392 patients were included (66% male, mean age 59.8 ± 11.6 years, mean duration of hypertension 11.4 ± 9.5 years). Preference for renal denervation was expressed by 755 patients (31.6%), and was higher in males than in females, in younger compared with older patients, in those with higher versus lower blood pressure, in patients who were less adherent versus more adherent to antihypertensive drug therapy, and in those who did rather than did not have antihypertensive drug-related side effects. Significant predictors of preference for renal denervation on logistic regression analysis were younger patient age, male sex, higher home or office systolic blood pressure, poor antihypertensive drug adherence, the presence of heart failure, and the presence of side effects during treatment with antihypertensive drugs. Overall, a relevant proportion of Japanese patients with hypertension expressed a preference for renal denervation. This should be taken into account when making shared decisions about antihypertensive drug therapy.

scholarly journals Sex Differences in Spironolactone and the Active Metabolite Canrenone Concentrations and Adherence

Biomedicines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 137
Author(s):  
Laura E. J. Peeters ◽  
Leonardien K. Tjong ◽  
Wim J. R. Rietdijk ◽  
Teun van Gelder ◽  
Birgit C. P. Koch ◽  
...  
Keyword(s):  
Sex Differences ◽  
Resistant Hypertension ◽  
Active Metabolite ◽  
Drug Exposure ◽  
Antihypertensive Drugs ◽  
Controlled Trial ◽  
Linear Regression Models ◽  
Blood Concentrations ◽  
Males And Females ◽  
Post Hoc

We aim to investigate sex differences in blood concentrations of spironolactone and the active metabolite canrenone in resistant hypertension patients. Furthermore, sex differences in adherence for spironolactone and other antihypertensive drugs (AHDs) were studied. The patients in this post hoc study had all participated in a single-blind randomized controlled trial called RHYME-RCT (Dutch Trial Register, NL6736). Concentrations in blood of several AHDs were assessed in RHYME-RCT to investigate adherence to treatment. This allowed for a comparison of drug exposure to spironolactone and canrenone between males and females. In linear regression models, no statistically significant sex differences (N = 35) in spironolactone (B =−10.23, SE = 7.92, p = 0.206) or canrenone (B = 1.24, SE = 10.96, p = 0.911) concentrations after adjustment for dose and time between sampling and intake were found. Furthermore, no statistically significant differences in non-adherence to spironolactone were found between sexes (N = 54, male 15% vs. female 38%, p = 0.100), but non-adherence to spironolactone was associated with non-adherence to other AHDs (p ≤ 0.001). Spironolactone and canrenone concentrations were not different between males and females with resistant hypertension. Although not statistically significant, females were twice as likely to be non-adherent to spironolactone compared to males, and thereby also more likely to be non-adherent to other AHDs.

Sign in / Sign up

Export Citation Format

Share Document