Abstract:
OBJECTIVES:Treatment modifications--addition, uptitration, switching, and downtitration--are necessary to address issues such as unattained blood pressure goals, adverse drug events, drug cost, or patient dissatisfaction which lead to treatment discontinuation. This study assessed the patterns of treatment modifications, and compared the rates of treatment modification and time-to-treatment modification across five antihypertensive drug classes (ADCs). Additionally, the association between treatment modification strategies and the likelihood of treatment discontinuation was assessed. METHODS:This is a retrospective cohort study using the BlueCross-BlueShield of Texas commercial claims database (2008-2012). Treatment modifications that occurred within 1 year of starting hypertension treatment were identified. Patients who received treatment modifications were followed for 12 months to determine if and when they discontinued treatment. Cox regression models were used to determine the likelihood of treatment modification and treatment discontinuation. RESULTS:About 48.5% of patients received treatment modifications within 1 year of treatment initiation. Rates of treatment modification were significantly different across ADCs; angiotensin-converting enzyme inhibitor and angiotensin receptor blocker users were less likely to receive treatment modifications compared with other ADCs. Mean time-to-treatment modification was more than 100 days for adding and uptitrating, and more than 140 days for switching and downtitrating. Patients intensifying treatment by adding medications were about 25% (vs. uptitration) and 50% (vs. switching) less likely to discontinue treatment. CONCLUSION:Treatment modifications are common among newly treated hypertensive patients, and the rates vary significantly across ADCs. In the real world, treatment modifications occur much later than the 30-day timeline recommended by guidelines. Addition of drugs may be a preferred approach for intensifying treatment of patients at a high risk of treatment discontinuation.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Sonawane KB,Qian J,Garza KB,Wright BM,Zeng P,Ganduglia-Cazaban CM,Hansen RAdoi
10.1097/HJH.0000000000000806subject
Has Abstractpub_date
2016-03-01 00:00:00pages
548-57; discussion 557issue
3eissn
0263-6352issn
1473-5598pii
00004872-201603000-00024journal_volume
34pub_type
杂志文章abstract:OBJECTIVE:Low insulin sensitivity is closely related to both cardiovascular diseases and diabetes development. Still, correlates of insulin sensitivity have mainly been examined in cross-sectional studies. As far as we are aware, the longitudinal stability of insulin sensitivity in young men is largely unknown. We aime...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000632
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The objective of the present study was to characterize the spectrum of circadian blood pressure changes in type I diabetes at different stages of nephropathy by using two monitorings in each patient in order to avoid intra-individual variability. PATIENTS AND METHODS:A total of 80 type I diabetic subjects a...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200108000-00010
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:Few data are available comparing the effects of monotherapy and combination therapy on target organ damage. The PICXEL study compared the efficacy of a strategy based on first-line combination with perindopril/indapamide versus monotherapy with enalapril in reducing left ventricular hypertrophy (LVH) in hyper...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.hjh.0000187253.35245.dc
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:To study blood pressure and antihypertensive drug treatment in subjects with contrasting family histories of hypertension. SUBJECTS AND METHODS:We grouped 520 offspring examined in 1990 (mean +/- SD age 36 +/- 7 years) according to their parents' blood pressure screened in 1963-1964 as offspring of two normo...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the mean levels of blood pressure and hypertension (> or = 140 mmHg systolic or > or = 90 mmHg diastolic pressure or on treatment for hypertension) in the adult English population, and to evaluate any changes in the efficacy of hypertension management between 1994 and 2003. DESIGN/METHODS:Cross-s...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000226210.95936.bc
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:The effect of nifedipine, a 1,4-dihydropyridine calcium antagonist, on the expression of monocyte chemoattractant protein 1 (MCP-1) induced by angiotensin II (Ang II) was examined using vascular smooth muscle cells (VSMC) isolated from rat thoracic aorta. METHODS AND RESULTS:Ang II increased the expression o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000198031.30095.d1
更新日期:2006-01-01 00:00:00
abstract::An index of peripheral vascular resistance, derived from directly measured arterial pressure, has been developed and tested in an animal model. Assuming a mono-exponential character for diastole, the time constant for direct arterial pressure decay in the central aorta was obtained with high-fidelity recording techniq...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198512000-00009
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism-related differences in ACE concentration do not result in differences in angiotensin levels. METHODS AND RESULTS:To investigate whether this relates to differences in the contribution of the ACE C-domain and N-domain, we quantified, u...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f465d2
更新日期:2008-04-01 00:00:00
abstract:DESIGN:Because of uncertainties regarding the complete antihypertensive mechanism of action of beta-adrenoceptor antagonists, the present study determined whether vagal afferent neurons of humans and rats possess beta-adrenoceptors. Such a location would provide an appropriate target for beta-blockers to modulate neuro...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199506000-00009
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVES:Urocortin 1 (Ucn1) and the sympathetic nervous system both participate in cardiac and circulatory regulation, but little is known about their possible interactions. METHODS:We report the effects of Ucn1 on the cardiac sympathetic nerve activity (CSNA), haemodynamics and plasma catecholamines in normal sheep...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f01428
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:Enhanced central sympathetic outflow is an indicator of the prognosis of heart failure. Although the central sympatholytic drug moxonidine is an established therapeutic strategy for hypertension, its benefits for hypertensive heart failure are poorly understood. In the present study, we investigated the effe...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328364a2a1
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Although an exaggerated systolic blood pressure (SBP) response to exercise is a predictor of future hypertension and cardiovascular mortality, the underlying mechanisms are not fully understood. We tested the hypothesis that an exaggerated SBP response is associated with carotid atherosclerosis in a cross-sec...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000222758.54111.e2
更新日期:2006-05-01 00:00:00
abstract::The reported prevalence of left ventricular hypertrophy (LVH) in human hypertension is much lower than that among animals with experimental hypertension. With current methods of determining left ventricular mass by M-mode echocardiography, the standard error of a single estimate is high and consequently so is the SD o...
journal_title:Journal of hypertension
pub_type: 社论,评审
doi:10.1097/00004872-199816060-00001
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVE:To determine plasma aldosterone concentration (PAC) and plasma renin concentration (PRC) and aldosterone-to-renin ratio (ARR) values in a population attending a Clinic for Cardiovascular Risk Assessment in Children. METHODS:We assessed ARR and associated factors in a cohort of 287 children (137 female, 4-18 ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001571
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that insulin differently modifies vasoconstriction and recovery from vasoconstriction induced by endogenously released versus circulating norepinephrine, and to investigate the time-dependency of its effect METHODS:Healthy male subjects were studied. Norepinephrine was infused for 10 m...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Left-ventricular hypertrophy (LVH) is a marker of organ damage in hypertension and helps stratifying cardiovascular risk. Initial left-ventricular mass (LVM) is also a predictor of progression to hypertension, independently of initial blood pressure (BP) and other confounders. OBJECTIVES:To evaluate whether...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328343ce32
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:To gauge the effectiveness of a new Doppler test for renal artery stenosis (RAS), based on the pulsatility index of the blood flow velocity spectrum within several interlobar arteries of both kidneys. METHODS:Twenty normotensive volunteers and 49 hypertensive patients were investigated with ultrasound. Patie...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:The contribution of salt intake to the pathogenesis of hypertension holds longstanding interest. Recent studies employed the sensitivity of blood pressure (BP) to salt intake as an intermediate phenotype. The validity of this approach relative to the homogeneity of sodium-sensitive hypertension was investigat...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1097/00004872-200305000-00020
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:Some cases of pseudopheochromocytoma have been described among hypertensive patients with obstructive sleep apnea (OSA). This study examined whether a pathological rise of urinary metanephrines is a common feature in hypertensive OSA patients and, in such a case, whether the ventilation treatment during sleep...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001507
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The aim of this cross-sectional study was to investigate the association between consumption of sugar-sweetened and diet soft drinks with blood pressure (BP) in adolescents. METHODS:Fifth graders of 20 public schools were invited to participate in an intervention aimed at behavioral dietary changes and had t...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000800
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:Recent epidemiological studies have reported inverse associations between vitamin D status and blood pressure. The study aim is to determine if exposure to ultraviolet B radiation, which synthesizes vitamin D, lowers blood pressure, compared with ultraviolet A radiation. METHODS:Men and women (n = 119) with...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e328349666d
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:In clonal animal cells, certain angiotensin receptor blockers (ARB) activate the peroxisome proliferator-activated receptor-gamma (PPARgamma). The aim of this work was to validate that observation in human cells and humans. METHODS:We investigated the induction of in-vitro adipogenesis and the activation of ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000242405.68461.84
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:The present study aimed to assess the effect of the specific dipeptidyl peptidase IV (DPPIV) inhibitor sitagliptin on blood pressure and renal function in young prehypertensive (5-week-old) and adult spontaneously hypertensive rats (SHRs; 14-week-old). METHODS:Sitagliptin (40 mg/kg twice daily) was given by...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328341939d
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Lacidipine is a widely used calcium-channel blocker, which has both long-lasting antihypertensive activity and also antioxidant properties. Previous studies have demonstrated the ability of lacidipine to reduce the development of atherosclerotic lesions in several animal models. OBJECTIVE:The present study ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018100-00010
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:The objective of the present studies is to investigate if the enhanced expression of Gs alpha protein and their mRNA observed in various models of hypertensive rats is due to the expressed hypertrophy or hypertension. METHODS:Hypertension, in Sprague-Dawley rats was induced by the oral administration of the ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018080-00013
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:Previous studies on multicellular preparations have shown that hypertrophied cardiac muscle from the spontaneously hypertensive rat (SHR) has a prolonged action potential. The first aim of the present study was to determine whether the action potential of isolated left ventricular myocytes was similarly prolo...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199306000-00005
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:To characterize the in vivo vascular properties of the spontaneously hypertensive rat (SHR) renal vascular bed by examining vascular conductance/resistance responsiveness to vasoactive agents in vivo and determining whether the filtration surface area of glomerular capillaries is reduced. DESIGN AND METHODS:...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200108000-00020
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Poor adherence to treatment is one of the major problems in the treatment of hypertension. Self blood pressure measurement may help patients to improve their adherence to treatment. METHOD:In this prospective, randomized, controlled study coordinated by a university hospital, a total of 228 mild-to-moderate...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e328334f36b
更新日期:2010-03-01 00:00:00
abstract::Use of the aldosterone-to-renin ratio has controversially suggested that approximately 10% of hypertensives have primary aldosteronism, and most of these individuals are thought to have idiopathic hyperaldosteronism. The usual renin-angiotensin system control is intact in these individuals and is similar to that in lo...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/00004872-200201000-00003
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:Reflection of the finger pulse wave form is a valid measure of arterial stiffness, which may be continuously assessed during sleep. We investigated the relationships between sleep, sleep-disordered breathing, hypertension, and pulse propagation time (PPT) in patients with suspected sleep apnea. METHODS:The ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001111
更新日期:2016-12-01 00:00:00