Abstract:
BACKGROUND:Choice of antihypertensive drugs is also based on the expected burden of adverse events associated with each class of agents, and we have recently identified treatment discontinuation for adverse events as a measure of treatment tolerability frequently reported in randomized controlled trials (RCTs). OBJECTIVES:To investigate whether all classes of blood pressure (BP) lowering drugs increase discontinuations for adverse events when compared with placebo and whether risk of discontinuation is similar for all classes when compared in head-to-head RCTs. METHODS:RCTs of BP-lowering treatment were subdivided in groups according to class of drug compared with placebo or with other classes. Risk ratios and 95% confidence intervals of major cardiovascular events and of treatment discontinuations for adverse events were calculated (random-effects model). RESULTS:Thirty-eight placebo-controlled RCTs (147 788 patients) and 37 head-to-head RCTs (242 481 patients) provided comparative information on discontinuations for adverse events. All classes of drugs significantly increased discontinuations for adverse events over those occurring on placebo: risk ratio diuretics 2.23 (1.32-3.76), beta-blockers 2.88 (1.58-5.28), calcium antagonists 2.03 (1.17-3.56), angiotensin-converting enzyme inhibitors 2.78 (1.37-5.47), central agents 1.74 (1.24-2.45), with the single exception of angiotensin receptor blockers, which did not significantly increase adverse events over placebo [risk ratio 1.13 (0.78-1.62)]. Similarly, in head-to-head comparison RCTs with other classes, angiotensin receptor blockers were the only class associated with a significantly lower risk of adverse events [risk ratio 0.71 (0.58-0.87)] when head-to-head compared with other classes. Regression analysis also shows that incidence of discontinuations for adverse events is proportional to the number of antihypertensive and other cardiovascular drugs, which accounts for the high incidence of this outcome often found in groups randomized to placebo. CONCLUSION:Reduction of cardiovascular events by all classes of BP-lowering drugs is accompanied by increased treatment discontinuations for adverse events, except when angiotensin receptor blockers are used. Treatment discontinuations are also related to treatment often accompanying antihypertensive agents.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Thomopoulos C,Parati G,Zanchetti Adoi
10.1097/HJH.0000000000001052subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1921-32issue
10eissn
0263-6352issn
1473-5598journal_volume
34pub_type
杂志文章,meta分析,评审abstract:OBJECTIVES:Aldosterone is synthesized in extra-adrenal tissues such as the vasculature, heart and brain. The mechanisms underlying the effect of high salt intake on the development and acceleration of vascular injury and cardiac hypertrophy in the stroke-prone spontaneously hypertensive rats (SHRSP) are still not clear...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200103001-00017
更新日期:2001-03-01 00:00:00
abstract::To investigate the effects of changes in sodium balance on blood pressure and leucocyte sodium transport, normotensive first-degree relatives of hypertensive patients and control subjects were randomized to receive low- and high-salt diets for 2 weeks, separated by a wash-out period of 2 weeks. High-salt intake failed...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-198606000-00012
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:A genetic polymorphism in the angiotensin II type 2 receptor (AGTR2 +1675G/A) has been associated with left ventricular hypertrophy (LVH). We tested whether this polymorphism affects LVH and left ventricular geometry parameters in patients with essential hypertension and cardiovascular disease who are treated...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32833aa356
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Enhanced oxidative stress has been observed in hypertension, but the underlying mechanism has not been fully clarified. OBJECTIVE:To study the relationship between oxygen free radicals and hypertension, using platelets as a tool to measure the cellular production of superoxide anion (O2). DESIGN:Forty pati...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-200406000-00016
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence and treatment status of hypertension in South Africa. DESIGN:National cross-sectional survey. SETTING:13 802 randomly selected South Africans, 15 years and older, were visited in their homes in 1998. METHODS:Trained fieldworkers completed questionnaires on lifestyle and chronic...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200110000-00004
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Wide pulse pressure is a potent risk factor for atherosclerotic disease, and hypertension is induced by habitual alcohol drinking. This concise study investigated whether age affects the relationship between alcohol drinking and pulse pressure. METHODS:The participants were 99 661 male workers (20-69 years ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3280895b69
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In the past, different methods have been used to measure the carotid-femoral distance for the assessment of pulse wave velocity (PWV). However, the latest consensus published advises to use 80% of the direct straight carotid-femoral distance (D(0.8)) using either a flexible tape or a sliding c...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32835e2a2f
更新日期:2013-05-01 00:00:00
abstract::Measurements of exchangeable sodium, arterial pressure and plasma concentrations of active renin, angiotensin II, aldosterone, sodium and potassium were made in 35 hypertensive patients with renal artery stenosis, 30 having unilateral renal arterial lesions. Plasma urea was below 7 mmol/l in 24 of the patients with un...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198310000-00015
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVES:To evaluate the clinic and ambulatory blood pressure (BP)-lowering efficacy and safety of an aliskiren/amlodipine/hydrochlorothiazide (HCT) triple combination compared with the component dual combinations, in patients with moderate-to-severe hypertension. METHODS:This 8-week, double-blind, randomized, activ...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e328356b8ea
更新日期:2012-10-01 00:00:00
abstract::The relationships between five erythrocyte cation transport systems (Na(+)-K+ pump, Na(+)-K+ cotransport, Na(+)-Li+ countertransport and Na+ and K+ passive permeabilities) and plasma lipids (total plasma cholesterol, high-density lipoprotein cholesterol and triglycerides) were investigated in 129 male adult subjects w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199010000-00002
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To investigate the characteristics and expression of transforming growth factor (TGF)-beta receptor subtypes on vascular smooth muscle cells (VSMC) from spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats. METHODS:The effects of TGF-beta 1 on DNA synthesis were evaluated by [3H]-th...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199508000-00003
更新日期:1995-08-01 00:00:00
abstract::Hypertension in children and adolescents has gained ground in cardiovascular medicine, thanks to the progress made in several areas of pathophysiological and clinical research. These guidelines represent a consensus among specialists involved in the detection and control of high blood pressure in children and adolesce...
journal_title:Journal of hypertension
pub_type: 杂志文章,实务指引
doi:10.1097/HJH.0b013e32832f4f6b
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To determine adrenocorticotrophin dose-response relationships for increase of blood pressure and metabolic parameters of the Sprague-Dawley rat. METHODS:We injected 120 male Sprague-Dawley rats twice daily subcutaneously for 10 days with 0.5, 1, 5, 50, 100, 200 or 500 microg/kg synthetic adrenocorticotrophin...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816050-00006
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that in the stroke-prone spontaneously hypertensive rat (SHRSP), the pressor effect of selective dietary chloride loading depends on a positive external sodium balance. METHODS:In 43 male SHRSP fed a Japanese style diet containing a low normal amount of NaCl (0.4%), we compared the eff...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3283316cfc
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Abnormal vascular reactivity contributes to the pathophysiology of hypertension and hypertension-related organ damage. As the dietary content of fatty acids may affect the vascular responses, we investigated the relationship of endothelium-independent and endothelium-dependent vasodilation with the fatty acid...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000495
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:In essential hypertensive patients, blunted renal plasma flow responsiveness to angiotensin II suggests a pathologic increase in angiotensin II in the kidneys. This blunting has been associated with the angiotensinogen 235TT genotype. As several measures of renal function decline with age, we sought to determ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282ffb417
更新日期:2008-07-01 00:00:00
abstract::Nitric oxide formed by neuronal nitric oxide synthase (nNOS) in the brain, autonomic inhibitory (nitrergic) nerves, and heart plays important roles in the control of blood pressure. Activation of nitrergic nerves innervating the systemic vasculature elicits vasodilatation, decreases peripheral resistance, and lowers b...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0b013e32832e8ddf
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Orthostatic hypotension, blood pressure (BP) variability, and arterial stiffness are three markers of cardiovascular risk beyond the average BP. However, the relationships between these three parameters are not well known. AIM:To examine the relationships between orthostatic hypotension, BP variability, and...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002374
更新日期:2020-06-01 00:00:00
abstract::: We aimed to combine evidence from all heart failure trials that have investigated the effects of drugs with blood pressure (BP)-lowering properties to assess the extent to which such drugs reduce BP in heart failure, the association between the net change in BP between treatment arms and cause-specific outcomes and ...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析
doi:10.1097/HJH.0000000000002094
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of cyclosporine A (CsA; Sandimmun Neoral) on systemic and renal hemodynamics, tubular function, and sodium excretion in healthy volunteers. Furthermore, we studied whether CsA enhances the systemic and renal hemodynamic sensitivity to norepinephrine. METHODS:Eighteen healthy volunte...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-199715030-00014
更新日期:1997-03-01 00:00:00
abstract::Basal platelet function was measured in 35 40-year-old men with untreated mild essential hypertension and compared with 44 age-matched normotensive men. The groups differed significantly with respect to platelet size in venous blood (hypertensive, 7.46 +/- 0.10 X 10(-15) l versus normotensive, 7.11 +/- 0.09 X 10(-15) ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVE:It is not well known which exercise intensity is needed to obtain blood pressure reductions in response to endurance training. We therefore compared the effect of training at lower and higher intensity on blood pressure, and, in addition on other cardiovascular risk factors, in at least 55-year-old sedentary ...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e328322cf60
更新日期:2009-04-01 00:00:00
abstract::This study focuses on the relationship between some aspects of intra-erythrocytic sodium metabolism (intra-erythrocytic Na content, Na,Li-countertransport), blood pressure, and family history of hypertension, in a group of 84 randomly selected school children (45 males, 39 females). Na,Li-countertransport was signific...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198803000-00007
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVE:Intermedin (IMD), a novel member of the calcitonin/calcitonin gene-related peptide family, is involved in maintaining circulatory homeostasis and is a protective factor of heart and vessel. Here, we investigated the effects of IMD on cardiac hypertrophy in vivo and in vitro and explored the mechanisms involve...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000597
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Optimal medication use obscures the impact of physical activity on traditional cardiometabolic risk factors. We evaluated the relationship between step counts and carotid-femoral pulse wave velocity (cfPWV), a summative risk indicator, in patients with type 2 diabetes and/or hypertension. RESEARCH DESIGN AND...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001277
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Contrary to lay beliefs, current perceived stress is not consistently associated with the incidence of high blood pressure (BP) in prospective studies, possibly because of moderating factors. The present prospective study examined this association and explored the potential moderating effects of sex or occup...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000288
更新日期:2014-10-01 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:OBJECTIVE:To assess the trends in blood pressure (BP) and in body mass index (BMI) in the hypertensive and normotensive population in Finland during 1982-1997. DESIGN:Four independent cross-sectional standardized population surveys were conducted in 1982, 1987, 1992 and 1997. SETTING:The provinces of North Karelia an...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018030-00003
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hyperactivity of the brain renin-angiotensin (Ang) system has been implicated in the development and maintenance of hypertension. AngIII, one of the main effector peptides of the brain renin-Ang system, exerts a tonic stimulatory control over blood pressure (BP) in hypertensive rats. Aminopepti...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001563
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:The pathogenesis of atherosclerosis, a chronic inflammatory disease, is influenced by the renin-angiotensin system and especially by angiotensin II subtype 1 (AT1) receptor activation. Although pro-inflammatory properties of angiotensin II as well as anti-inflammatory effects of AT1 receptor antagonists are w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000242415.73406.17
更新日期:2006-09-01 00:00:00