scholarly journals The Association between Antihypertensive Medication Use and Blood Pressure Is Influenced by Obesity

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Jash S. Parikh ◽  
Arshdeep K. Randhawa ◽  
Sean Wharton ◽  
Heather Edgell ◽  
Jennifer L. Kuk
Keyword(s):  
Blood Pressure ◽  
Ace Inhibitors ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Normal Weight ◽  
Antihypertensive Medications ◽  
Glucose Levels ◽  
Health And Nutrition ◽  
Obesity Status ◽  
Main Effects

Introduction. One in three US adults is living with obesity or hypertension, and more than 75% of hypertensive individuals are using antihypertensive medications. Therefore, it is important to examine blood pressure (BP) differences in populations that are using these medications with differing obesity status. Aim. We examined whether BP attained when using various antihypertensive medications varies amongst different body mass index (BMI) categories and whether antihypertensive medication use is associated with differences in other metabolic risk factors, independent of BMI. Methods. Adults with hypertension from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 were used (n=15,285). Linear regression analyses were used to examine the main effects and interaction between antihypertensive use and BMI. Results. In general, users of antihypertensive medications had lower BP than those not taking BP medications (NoBPMed) (P<0.05), whereby in women, the differences in systolic BP between angiotensin-converting-enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) users and NoBPMed were greater in those with obesity (ACE inhibitors: −14 ± 1 mmHg; ARB: −16 ± 1 mmHg) compared to normal weight individuals (ACE inhibitors: −9 ± 1 mmHg; ARB: −11 ± 1 mmHg) (P<0.05). Diastolic BP differences between women ARB users and NoBPMed were also greatest in obesity (−5 ± 1 mmHg) (P<0.05) whilst there were no differences in normal weight individuals (−1 ± 1 mmHg) (P>0.05). Furthermore, glucose levels and waist circumference in women were higher in those using ACE inhibitors compared to diuretics (P<0.05). Conclusion. ACE inhibitors and ARBs may be associated with more beneficial BP profiles in women with obesity, with no obesity-related BP differences for antihypertensive medication in men. However, there could be potential cardiometabolic effects for some antihypertensive medications that should be explored further.

scholarly journals The longitudinal association between the use of antihypertensive medications and 24-hour sleep in nursing homes: results from the randomized controlled COSMOS trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elisabeth Flo-Groeneboom ◽  
Tony Elvegaard ◽  
Christine Gulla ◽  
Bettina S Husebo
Keyword(s):  
Blood Pressure ◽  
Nursing Home ◽  
Antihypertensive Medication ◽  
Sleep Problems ◽  
Medication Use ◽  
Control Group ◽  
Antihypertensive Medications ◽  
Randomized Controlled ◽  
Nursing Home Patients ◽  
Longitudinal Association

Abstract Background Antihypertensive medication use and sleep problems are highly prevalent in nursing home patients. While it is hypothesized that blood pressure and antihypertensive medication use can affect sleep, this has not been investigated in depth in this population. Alongside a multicomponent intervention including a systematic medication review, we aimed to investigate the longitudinal association between antihypertensive medication use, blood pressure and day- and night-time sleep over 4 months. Methods This study was based on secondary analyses from the multicomponent cluster 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 medication use, and sleep parameters as assessed by actigraphy. Results We found a significant reduction in total sleep time at month four in the intervention group compared to the control group. When analysing the control group alone, we found a significant association between antihypertensive medication use and increased daytime sleep. We also found negative associations between blood pressure, antihypertensive medication use and sleep onset latency in the control group. Conclusions Our results suggest a correlation between excessive daytime sleep and antihypertensive medication use. These findings should be followed up with further research, and with clinical caution, as antihypertensive medications are frequently used in nursing homes, and sleep problems may be especially detrimental for this population. Trial registration The trial is registered at clinicaltrials.gov (NCT02238652).

Abstract 54: Gender Differences In Blood Pressure Control Is Mediated By Age In United States Adults

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Aayush Visaria ◽  
Fariha Hameed ◽  
Brinda Raval ◽  
Sumaiya Islam
Keyword(s):  
Blood Pressure ◽  
Gender Differences ◽  
Older Women ◽  
Survey Design ◽  
Age Groups ◽  
Medication Use ◽  
Pressure Control ◽  
Antihypertensive Medications ◽  
Health And Nutrition ◽  
Public Health Challenge

Introduction: Blood pressure (BP) control remains a major public health challenge. Little is known about the gender differences in BP control across the age spectrum. We determined the age-stratified associations between gender and uncontrolled HTN. Methods: We included adults ≥20 years who reported HTN diagnosis and antihypertensive medication use from the 1999-2018 National Health and Nutrition Examination Surveys. Mean BP was calculated as the average of 3 consecutive BP readings 30 seconds apart. Uncontrolled HTN was considered as BP ≥140/90. We used survey design-adjusted multivariable logistic regression to determine the odds of uncontrolled HTN in women vs. men, adjusting for demographic, sociobehavioral, metabolic, and comorbid factors. Results: Among 13,253 participants taking antihypertensive medications (mean age 57, 52% female, 71% White), 34% had HTN (35% women, 33% men). Upon stratifying by 10-year age groups, men had higher odds of uncontrolled HTN from age 20 to 49 years, followed by a period of insignificantly different odds of uncontrolled HTN from age 50-69 years (Table). Among participants ≥70 years, females had significantly higher adjusted odds of uncontrolled HTN. These associations persisted when using the 2017 ACC/AHA guidelines. Conclusion: Women have significantly higher odds (>20%) of uncontrolled HTN compared to men starting age 70. This may suggest that interventions to improve BP control in older women are warranted. The changes in the gender differences across the age spectrum warrant further evaluation.

scholarly journals Changes in Blood Pressure Levels and Antihypertensive Medication Use before and after Renal Transplantation among Patients in Nairobi, Kenya: A Comparative Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Mary N. Kubo ◽  
Joshua K. Kayima ◽  
Anthony J. Were ◽  
Mohammed S. Ezzi ◽  
Seth O. McLigeyo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Transplantation ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Cross Sectional Study ◽  
Renal Transplant Recipients ◽  
Sectional Study ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Before And After

Objectives.To determine the changes in blood pressure levels and antihypertensive medication use in the postrenal transplantation period compared to pretransplantation one.Methods. A comparative cross-sectional study was carried out on renal transplant recipients at the Kenyatta National Hospital, a national referral hospital in Kenya. Sociodemographic details, blood pressure levels, and antihypertensive medication use before and after renal transplantation were noted. Changes in mean blood pressure levels and mean number of antihypertensive medications after renal transplantation were determined using pairedt-test.Results. 85 subjects were evaluated. Mean age was 42.4 (SD ± 12.2) years, with a male : female ratio of 1.9 : 1. Compared to the pretransplant period, significantly lower mean systolic and diastolic blood pressure levels after transplantation were noted (mean SBP 144.5 mmHg versus 131.8 mmHg; mean DBP 103.6 mmHg versus 83.5 mmHg in the pre- and posttransplant periods, respectively,p<0.001). Mean number of antihypertensive medications also reduced significantly after transplantation, with an average of 3.3 (±1.6) versus 2.1 (±0.9) in the pre- and posttransplant periods, respectively (p<0.001).Conclusion. There is a significant reduction in blood pressure levels and number of antihypertensive medications used after renal transplantation. The positive impact of renal transplantation on blood pressure control should be confirmed using prospective cohort studies of patients with end stage renal disease who then undergo renal transplantation.

Association between office blood pressure, antihypertensive medication use and male sexual dysfunction: a penile Doppler study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Ioakeimidis ◽  
K Rokkas ◽  
D Terentes-Printzios ◽  
A Angelis ◽  
I Dima ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Antihypertensive Drugs ◽  
Medication Use ◽  
Peak Systolic Velocity ◽  
Fold Increase ◽  
Hypertension Status ◽  
Antihypertensive Medications ◽  
Doppler Study ◽  
Arterial Insufficiency

Abstract Background Arterial hypertension is associated with an almost two-fold increase in the likelihood of having an abnormal penile blood flow. Recent evidence supports the independent of age and blood pressure (BP) level predictive value of severe penile arterial insufficiency for adverse cardiovascular events. Purpose Aim of this study is to quantify the association between BP level and severity of penile vascular disease and to examine the potential for differences in effect of BP lowering medication use on the associations between BP level and penile vascular damage. Methods We measured penile peak systolic velocity (PSV) in 356 consecutive men with erectile dysfunction (ED) and without a history of diabetes and cardiovascular disease; The cohort was divided according to office systolic BP (SBP) and diastolic BP in three BP categories: normal (SBP &lt;130 and DBP &lt;85 mmHg, n=117), high normal (130≤SBP&lt;140 or DBP 85≤DBP&lt;90mmHg, n=91), and hypertension (SBP≥140 or DBP≥90mmHg, n=148). 164 (46%) patients of the whole study population were treated with antihypertensive medications. Low PSV values after intracavernous injection of prostanglandin E1 indicate impaired penile blood inflow and severe vasculogenic ED. Results Figure shows PSV measurements of the three office BP categories subdivided according to use of antihypertensive therapy. Treated and untreated hypertensive patients had similar mean PSV. Interestingly, the mean PSV of men with high normal BP not receiving antihypertensive drugs was significantly higher compared to PSV of men with high normal BP under therapy and significantly lower compared to PSV of normotensive males without therapy (all P&lt;0.05). Among males not receiving antihypertensive medications there was a progressive decrease in PSV values from normal BP, to high normal BP and to hypertension (P=0.01, after adjustment for age), while among males under antihypertension therapy, the three BP categories had similar PSV level (P=0.54 after adjustment for age) (figure). Conclusion The inverse associations observed between hypertension status and penile arterial insufficiency in men not taking antihypertensive medication were attenuated or disappeared among men reporting antihypertensive medication use reflecting a medication effect or structural effects of longstanding hypertension on the penile vasculature. BP level, hypertension therapy and PSV Funding Acknowledgement Type of funding source: None

scholarly journals Trends in Awareness, Antihypertensive Medication Use and Blood Pressure Control by Race and Ethnicity Among Adults with Hypertension in the United States: A National Health and Nutrition Examination Analysis from 2011 to 2018

2021 ◽  
Author(s):  
Yuan Lu ◽  
Yuntian Liu ◽  
Lovedeep S Dhingra ◽  
Daisy Singh Massey ◽  
Cesar Caraballo ◽  
...  
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Ethnic Differences ◽  
National Health ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Health And Nutrition ◽  
Hypertension Awareness ◽  
And Control ◽  
Racial Ethnic

Objective: To examine United States (US) trends in racial/ethnic differences in hypertension awareness and antihypertensive medication use, and whether these differences help explain racial/ethnic differences in hypertension control among adults from 2011 to 2018. Design: Population-based study. Setting: National Health and Nutrition Examination Survey (NHANES), 2011-2018. Participants: A nationally representative sample of US adults aged 18 years or older. Main outcome measures: Hypertension awareness was defined as self-reported physician diagnosis of hypertension. Antihypertensive treatment was based on self-reported use of antihypertensive agents. Blood pressure (BP) control was measured systolic BP <140 mmHg and diastolic BP <90 mmHg. Results: This study included 8,095 adults with hypertension from NHANES 2011-2018. During the study period, age-adjusted hypertension awareness declined from 84.0% (95% confidence interval 79.5 to 86.2) to 77.5% (74.0 to 80.5), hypertension treatment declined from 77.3% (73.4 to 81.1) to 71.4% (69.0 to 73.8) and control rates declined from 51.9% (47.1 to 56.7) to 43.1% (39.7 to 46.5). These declines were consistent for Black, Hispanic, and White individuals, but the three outcomes increased or did not change for Asian individuals. Compared with White individuals, Black individuals did not have a significantly different awareness (odds ratio:1.20 [0.96 to 1.45]) and overall treatment rate (1.04 [0.84 to 1.25]), but received more antihypertensive medications if treated (1.41 [1.27 to 1.56]), and had a lower BP control rate (0.72 [0.61 to 0.83]); Asian and Hispanic individuals had significantly lower awareness rates (0.69 [0.52 to 0.85] and 0.74 [0.59 to 0.89], respectively), overall treatment rates (0.72 [0.57 to 0.88] and 0.69 [0.55 to 0.82]), received fewer medications if treated (0.60 [0.50 to 0.72] and 0.86 [0.75 to 0.96]), and had lower BP control rates (0.66 [0.54 to 0.79] and 0.69 [0.57 to 0.81]). The racial/ethnic differences in awareness, treatment, and BP control persisted over the study period and were consistent across age, sex, and income strata. Lower awareness and treatment were associated with lower BP control in Asian and Hispanic individuals, but not in Black individuals. Conclusions: Hypertension awareness, treatment, and control declined from 2011-2018, and this decline was consistent for Black, Hispanic, and White individuals. BP control was worse for Asian, Black, and Hispanic individuals than for White individuals over the entire study period; this was explained partly by differences in awareness and treatment for Asian and Hispanic individuals, but not for Black individuals.

Abstract P091: Reasons For Uncontrolled Blood Pressure Among US Adults

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Swati Sakhuja ◽  
Calvin Colvin ◽  
Oluwasegun Akinyelure ◽  
Shakia T Hardy ◽  
Paul Muntner
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Self Report ◽  
Medication Regimen ◽  
Uncontrolled Blood Pressure ◽  
Surgeon General ◽  
Health And Nutrition ◽  
Hypertension Awareness ◽  
History Of ◽  
Healthcare Visit

Introduction: In October 2020, the US Surgeon General issued a Call to Action on hypertension control. We investigated the contribution of lack of awareness, not taking antihypertensive medication and an inadequate antihypertensive medication regimen to uncontrolled blood pressure (BP) among US adults. Methods: We analyzed data for 2,282 participants ≥18 years of age with uncontrolled BP from the 2015-2016 and 2017-2018 National Health and Nutrition Examination Surveys (NHANES). BP was measured three times by a trained physician following a standardized protocol. Uncontrolled BP was defined by systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg. Being aware of having hypertension and antihypertensive medication use were defined by self-report. An inadequate antihypertensive medication regimen was defined as taking antihypertensive medication with uncontrolled BP. Data were weighted to represent the non-institutionalized US population. Results: Among US adults with uncontrolled BP, 34.8% were not aware they had hypertension, 13.8% were aware but not taking antihypertensive medication and 51.4% were aware but taking inadequate antihypertensive medication regimen. US adults 18-39 and 40-49 years of age were more likely to be unaware they had hypertension compared to their counterparts ≥70 years of age (multivariable-adjusted prevalence ratios [PR]: 1.62 [95% CI: 1.26-2.07] and 1.41 [95% CI: 1.02-1.95], respectively). Participants who had a healthcare visit in the past year (PR: 0.60 [95% CI: 0.47-0.77]) and who were obese (PR: 0.69 [95% CI: 0.56-0.85]), had diabetes (PR: 0.56 [95% CI: 0.42-0.76]), chronic kidney disease (PR: 0.59 [95% CI: 0.46-0.75]) and a history of cardiovascular disease (PR: 0.41 [95% CI: 0.27-0.61]) were less likely to be unaware they had hypertension. Among those who were aware they had hypertension, US adults who were 18-39 and 40-49 years of age as compared to those ≥70 years of age were more likely to be not taking antihypertensive medication versus taking inadequate antihypertensive medication regimen (multivariable-adjusted PR: 5.48 [95% CI: 3.17-9.48] and 5.14 [95% CI: 2.28-10.26], respectively). In contrast, non-Hispanic blacks and Hispanics as compared to non-Hispanic whites (PR: 0.71 [95% CI: 0.53-0.94] and 0.72 [95% CI: 0.54-0.96], respectively) and those without a usual place to receive healthcare (PR: 0.70 [95% CI 0.51-0.96]) and who had a healthcare visit in past year (PR: 0.47 [95% CI: 0.35-0.62]) were less likely to be not taking antihypertensive medication versus taking inadequate antihypertensive medication regimen. Conclusion: The majority of US adults with uncontrolled BP were either unaware they had hypertension or were taking an inadequate antihypertensive medication regimen. Interventions are needed to increase hypertension awareness and assess and titrate patients’ antihypertensive medication regimen.

Abstract MP61: Greater Late-life Physical Function Declines Among Older Adults With Higher Blood Pressure In Mid-life: The Atherosclerosis Risk In Communities (ARIC) Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Laura Skow ◽  
J Coresh ◽  
J Deal ◽  
Rebecca F Gottesman ◽  
Jennifer Schrack ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Physical Function ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Late Life ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Continuous Analysis ◽  
Aric Study

Introduction: Greater late-life physical function decline is associated with incident adverse outcomes including disability and death. Hypertension is the strongest risk factor for stroke, the major cause of physical disability. Hypertension in mid-life has previously been associated with poor physical functioning in late-life; however, more evidence is needed to evaluate whether higher blood pressure in mid-life is associated with the rate of physical function decline during late-late in the absence of stroke. We hypothesized that elevated blood pressure in mid-life would be associated with greater physical function declines in late life. Methods: We studied 5,559 older adults in the ARIC Study (Visit 5; mean age: 75.8 years; range: 66.7-90.9 years; 58% women; 21% Black/79% White) without prior stroke or Parkinson disease who completed the Short Physical Performance Battery (SPPB, scored 0-12). Repeated SPPB assessments occurred at Visits 6 and 7 (median follow-up: 4.2 years). The exposure was a history of elevated blood pressure (BP) (Visit 1; mean age: 52.0 years; mean gap between mid- and late-life exams: 23.7 years). BP was modeled both categorically (hypertensive: SBP 140+ mmHg, DBP 90+ mmHg, or antihypertensive medication use; pre-hypertensive: SBP 120-139 mmHg or DBP 80-89 mmHg; else normotensive) and continuously. Random-slope, random-intercept mixed models with an independent covariance structure tested the association between BP and SPPB score change, adjusted for age, sex, race-site, BMI, education, heart disease and heart failure. Continuous analysis also adjusted for antihypertensive medication use. Results: SPPB scores declined an average of 1.60 points per 10 years (95% CI: -1.75, -1.46; p<0.001) among older adults who were normotensive in mid-life. Older adults with a previous measurement of hypertension declined an additional 0.94 points per 10 years (95% CI: -1.27, -0.60; p<0.001). Prehypertension was not statistically significantly associated with additional decline compared to mid-life normotension (estimate: -0.19 SPPB points/10 years; 95% CI: -0.53, 0.16; p=0.293). In the continuous analysis, each additional 10 mmHg higher mid-life systolic blood pressure above 120 mmHg was associated with an additional 0.24 point decline in SPPB per 10 years in late-life (95% CI: -0.31,-0.14; p<0.001). Conclusions: Elevated BP in mid-life provides insight into the rate of physical function decline decades later, with higher mid-life systolic blood pressure corresponding with steeper declines in late-life physical function even in the absence of stroke. Future research should investigate whether elevated blood pressure at multiple points in mid-life further informs the association.

Association Between Cost-Related Medication Nonadherence and Hypertension Management Among US Adults

2020 ◽  
Vol 33 (9) ◽  
pp. 879-886 ◽  
Author(s):  
Jing Fang ◽  
Tiffany Chang ◽  
Guijing Wang ◽  
Fleetwood Loustalot
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Medication ◽  
Medication Use ◽  
Normal Blood ◽  
Hypertension Management ◽  
Normal Blood Pressure ◽  
Medication Nonadherence ◽  
Financial Barriers ◽  
The Past ◽  
Prevalence Ratios

Abstract BACKGROUND Medication nonadherence is an important element of uncontrolled hypertension. Financial factors frequently contribute to nonadherence. The objective of this study was to examine the association between cost-related medication nonadherence (CRMN) and self-reported antihypertensive medication use and self-reported normal blood pressure among US adults with self-reported hypertension. METHODS Participants with self-reported hypertension from the 2017 National Health Interview Survey were included (n = 7,498). CRMN was defined using standard questions. Hypertension management included: (i) self-reported current antihypertensive medication use and (ii) self-reported normal blood pressure within the past 12 months. Adjusted prevalence and prevalence ratios of hypertension management indicators among those with and without CRMN were estimated. RESULTS Overall, 10.7% reported CRMN, 83.6% reported current antihypertensive medication use, and 67.4% reported normal blood pressure within past 12 months. Adjusted percentages of current antihypertensive medication use (88.6% vs. 82.9%, P &lt; 0.001) and self-reported normal blood pressure (69.8% vs. 59.5%, P = 0.002) were higher among those without CRMN compared with those with CRMN. Adjusted prevalence ratios showed that, compared with those with CRMN, those without CRMN were more likely to report current antihypertensive medication use (odds ratio = 1.08, 95% confidence interval 1.04–1.12) and self-reported normal blood pressure (1.15 (1.07–1.23)). CONCLUSIONS Among US adults with self-reported hypertension, those without CRMN were more likely to report current antihypertensive medication use and normal blood pressure within the past 12 months. Financial barriers to medication adherence persist and impact hypertension management.

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