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A 52-week prospective, cohort study of the effects of losartan with or without hydrochlorothiazide (HCTZ) in hypertensive patients with metabolic syndrome.

https://arctichealth.org/en/permalink/ahliterature145472
Source
J Hum Hypertens. 2010 Nov;24(11):739-48
Publication Type
Article
Date
Nov-2010
Author
N. Racine
P. Hamet
J S Sampalis
N. Longo
N. Bastien
Author Affiliation
Department of Medicine, Montreal Heart Institute, Montréal, Québec, Canada.
Source
J Hum Hypertens. 2010 Nov;24(11):739-48
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Antihypertensive Agents - adverse effects - therapeutic use
Biological Markers - blood
Blood Glucose - drug effects - metabolism
Blood Pressure - drug effects
Calcium Channel Blockers - therapeutic use
Canada
Chi-Square Distribution
Diabetes Mellitus - blood - chemically induced
Diuretics - adverse effects - therapeutic use
Drug Therapy, Combination
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hydrochlorothiazide - adverse effects - therapeutic use
Hypertension - blood - complications - drug therapy - physiopathology
Linear Models
Losartan - adverse effects - therapeutic use
Male
Metabolic Syndrome X - blood - complications - physiopathology
Middle Aged
Prospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
The impact of an ARB, with or without hydrochlorothiazide (HCTZ), on glycaemic factors and the risk for developing diabetes in hypertensive patients with the metabolic syndrome have not been fully assessed. This was a 52-week multicentre, prospective, phase-IV, open-label, cohort study of losartan or losartan/HCTZ in hypertensive patients with metabolic syndrome. All subjects were treated initially with losartan 50?mg?day(-1). Those not achieving target blood pressure (BP
PubMed ID
20147971 View in PubMed
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Adverse drug effects and the need for drug information.

https://arctichealth.org/en/permalink/ahliterature226228
Source
Med Care. 1991 Jun;29(6):558-64
Publication Type
Article
Date
Jun-1991
Author
H. Enlund
K. Vainio
S. Wallenius
J W Poston
Author Affiliation
Department of Social Pharmacy, University of Kuopio, Finland.
Source
Med Care. 1991 Jun;29(6):558-64
Date
Jun-1991
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Antihypertensive Agents - adverse effects - therapeutic use
Drug Information Services
Female
Finland
Hospitals
Humans
Hypertension - drug therapy
Male
Middle Aged
Patient Education as Topic
Questionnaires
Abstract
The information needs of a group of patients taking antihypertensive medication were assessed with special emphasis on the influence of perceived symptoms of high blood pressure and adverse drug effects. All patients of a hypertension clinic currently on antihypertensive medication were included in the study. The response rate to the questionnaire was 85%. Of the 623 patients included, only 31% expressed satisfaction with the amount of information received on adverse effects of their antihypertensive drugs. Patients younger than 50 years explicitly expressed a need for information more often than those older than 64. There were no differences in the expressed information needs between men and women. The reported experience of symptoms related to high blood pressure and adverse drug effects was more common among younger patients than among the elderly. Of those who experienced both adverse drug effects and symptoms, 57% expressed a need for more information, whereas only 30% of those who had no such experiences expressed a need for more information on adverse drug effects. It was concluded that there is a substantial need for more information on adverse drug effects, especially among those who have experienced adverse drug effects or some symptoms of hypertension.
PubMed ID
2046409 View in PubMed
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Antihypertensive therapy and incidence of type 2 diabetes in an elderly cohort.

https://arctichealth.org/en/permalink/ahliterature178189
Source
Diabetes Care. 2004 Oct;27(10):2458-63
Publication Type
Article
Date
Oct-2004
Author
Raj Padwal
Muhammad Mamdani
David A Alter
Jan E Hux
Deanna M Rothwell
Karen Tu
Andreas Laupacis
Author Affiliation
Division of General Internal Medicine, University of Alberta, Edmonton, Canada. rpadwal@ualberta.ca
Source
Diabetes Care. 2004 Oct;27(10):2458-63
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors - adverse effects - therapeutic use
Antihypertensive Agents - adverse effects - therapeutic use
Benzothiadiazines
Calcium Channel Blockers - adverse effects - therapeutic use
Cohort Studies
Diabetes Mellitus, Type 2 - chemically induced - epidemiology
Diuretics
Female
Geriatric Assessment
Humans
Hypertension - diagnosis - drug therapy
Incidence
Male
Ontario - epidemiology
Probability
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk assessment
Sex Distribution
Sodium Chloride Symporter Inhibitors - adverse effects - therapeutic use
Abstract
The aim of this study was to determine whether the incidence of type 2 diabetes differed among elderly users of four major antihypertensive drug classes.
This was a retrospective, observational cohort study of previously untreated elderly patients (aged > or = 66 years) identified as new users of an antihypertensive drug class between April 1995 and March 2000. Using a Cox proportional hazards model, the primary analysis compared diabetes incidence in users of ACE inhibitors, beta-blockers, and calcium channel blockers (CCBs), with thiazide diuretics allowed as second-line therapy. In the secondary analysis, thiazide diuretics were added as a fourth study group.
In the multivariable-adjusted primary analysis (n = 76,176), neither ACE inhibitor use (hazard ratio 0.96 [95% CI 0.84-1.1]) nor beta-blocker use (0.86 [0.74-1.0]) was associated with a statistically significant difference in type 2 diabetes incidence compared with the CCB control group. In the secondary analysis (n = 100,653), compared with CCB users, type 2 diabetes incidence was not significantly different between users of ACE inhibitors (0.97 [0.83-1.1]), beta-blockers (0.84 [0.7-1.0]), or thiazide diuretics (1.0 [0.89-1.2]).
Type 2 diabetes incidence did not significantly differ among users of the major antihypertensive drug classes in this elderly, population-based administrative cohort. These results do not support the theory that different antihypertensive drug classes are relatively more or less likely to cause diabetes.
Notes
Comment In: Diabetes Care. 2005 Mar;28(3):762; author reply 762-315735235
PubMed ID
15451916 View in PubMed
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Anxiety and depression symptoms in arterial hypertension: the influence of antihypertensive treatment. the HUNT study, Norway.

https://arctichealth.org/en/permalink/ahliterature128652
Source
Eur J Epidemiol. 2012 Jan;27(1):63-72
Publication Type
Article
Date
Jan-2012
Author
Aslak Johansen
Jostein Holmen
Robert Stewart
Ottar Bjerkeset
Author Affiliation
Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Source
Eur J Epidemiol. 2012 Jan;27(1):63-72
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - adverse effects - therapeutic use
Anxiety - chemically induced - complications
Blood Pressure Determination
Cross-Sectional Studies
Depression - chemically induced - complications
Drug Therapy, Combination
Female
Health Surveys
Humans
Hypertension - complications - drug therapy - psychology
Logistic Models
Male
Middle Aged
Norway
Odds Ratio
Self Report
Abstract
Antihypertensive drugs have been suggested to modulate symptoms of depression and anxiety. It is disputed whether this is due to the hypertension per se, its treatment, or both. The aim of this study was to investigate these associations in a large population sample. 55,472 participants in the Nord-Trøndelag Health Study (HUNT 2, 1995-1997), Norway, who completed the Hospital Anxiety and Depression rating Scale, were divided into 3 groups according to their diastolic blood pressure and antihypertensive treatment status. A cut-off of =90 mmHg diastolic blood pressure was used to identify hypertensive status. Differences in anxiety and depression symptom levels in untreated and treated hypertensives (all treatments) versus the normotensive reference group were explained by differences in age and gender distribution in the three groups in this study. However, the receipt of two or more antihypertensive drugs was associated with depressive symptoms alone (OR = 1.40, 95% CI = 1.03-1.90), but not with symptoms of anxiety (OR = 1.14, 95% CI = 0.83-1.57) or mixed anxiety and depression (OR = 1.19, 95% CI = 0.82-1.72) in the fully adjusted model, compared to untreated hypertension. Antihypertensive monotherapy (all agents) nor any single antihypertensive drug class were associated with symptoms of depression, anxiety, or mixed anxiety and depression. There may be a positive association between multi antihypertensive drug use and symptoms of depression, whereas this was not found in persons with symptoms of anxiety or mixed anxiety and depression. This might reflect poor antihypertensive treatment adherence leading to polypharmacy, or other unfavorable health behaviors in people with symptoms of pure depression.
PubMed ID
22183137 View in PubMed
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Atenolol as initial antihypertensive therapy: an observational study comparing first-line agents.

https://arctichealth.org/en/permalink/ahliterature163066
Source
J Hypertens. 2007 Jul;25(7):1499-505
Publication Type
Article
Date
Jul-2007
Author
David F Blackburn
Darcy A Lamb
Dean T Eurich
Jeffrey A Johnson
Thomas W Wilson
Roy T Dobson
James L Blackburn
Author Affiliation
College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. d.blackburn@usask.ca
Source
J Hypertens. 2007 Jul;25(7):1499-505
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - adverse effects - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - adverse effects - therapeutic use
Antihypertensive Agents - adverse effects - therapeutic use
Atenolol - adverse effects - therapeutic use
Calcium Channel Blockers - adverse effects - therapeutic use
Canada - epidemiology
Cardiovascular Diseases - complications - mortality
Cohort Studies
Databases, Factual
Humans
Hypertension - complications - drug therapy - mortality
Odds Ratio
Retrospective Studies
Sodium Chloride Symporter Inhibitors - adverse effects - therapeutic use
Survival Rate
Abstract
The role of atenolol in the management of patients with hypertension is currently under scrutiny. Our aim was to evaluate the real-world consequences of recent clinical trial findings.
We conducted a retrospective, cohort study using linked administrative data from the province of Saskatchewan, Canada. Eligible subjects were first-ever users of antihypertensive medications between 1 January 1994 and 31 December 2003 and were grouped into four cohorts: atenolol, angiotensin-converting enzyme inhibitors (ACEI), thiazide diuretics, or calcium antagonists. Patients remained eligible during monotherapy only.
We identified 19 249 eligible individuals (mean age 60.6 years) who were followed for a mean of 2.3 years (SD 2.0). The rate of myocardial infarction, unstable angina, stroke, or death occurred in similar frequencies among all cohorts: atenolol (2.3%), ACEI (3.6%), thiazide diuretics (2.9%), and calcium antagonists (3.9%). After adjustment for potential confounders, atenolol therapy was not associated with higher event rates than the other first-line agents, with hazard ratios ranging between 1.03 [95% confidence intervals (CI) 0.72-1.46] and 1.24 (95% CI 0.91-1.68) for all cohorts compared with atenolol. Similar results were observed upon stratifying the sample into subjects above and below 60 years of age.
The low event rates for all cohorts suggest that atenolol has not been associated with a significant burden of cardiovascular morbidity or mortality in its traditional role for uncomplicated hypertension. Further study is needed to identify the specific types of patients that should avoid atenolol as an antihypertensive agent.
Notes
Comment In: J Hypertens. 2007 Jul;25(7):1351-317563554
PubMed ID
17563574 View in PubMed
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The BBB Study: the effect of intensified antihypertensive treatment on the level of blood pressure, side-effects, morbidity and mortality in "well-treated" hypertensive patients. Behandla Blodtryck B├Ąttre.

https://arctichealth.org/en/permalink/ahliterature73165
Source
Blood Press. 1994 Jul;3(4):248-54
Publication Type
Article
Date
Jul-1994
Author
L. Hannson
Source
Blood Press. 1994 Jul;3(4):248-54
Date
Jul-1994
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - adverse effects - therapeutic use
Blood Pressure - drug effects
Female
Heart Rate - drug effects
Humans
Hypertension - drug therapy - mortality - physiopathology
Male
Middle Aged
Research Support, Non-U.S. Gov't
Abstract
The BBB study (Swedish for Behandla Blodtryck B?ttre or Treat Blood Pressure Better) was a multicenter trial designed to investigate three aspects of antihypertensive treatment: i) Is it possible to lower the diastolic blood pressure further in "well-treated" hypertensive patients through intensified therapy? ii) Can this aim be fulfilled without increasing the incidence or severity of side-effects? iii) If i) and ii) can be answered in the affirmative, will the further reduction in diastolic blood pressure be associated with a further reduction in hypertension-associated mortality and morbidity? Altogether 2127 hypertensive men and women with an average age of 59.8 years (46-71) were recruited at 142 primary health care centers in Sweden. Approximately 10,000 patient-years were accumulated. All patients had treated essential hypertension and all had diastolic blood pressures in the range 90-100 mmHg on three consecutive visits before entering the study. The patients were randomized to either intensified treatment aiming at a blood pressure 4 years. Adverse effects were studied in detail in 100 randomly selected patients from each group using a special questionnaire and a visual analogue scale. The adverse effect score fell significantly in group A but remained unchanged in group B. Regarding cardiovascular morbidity and mortality there were no significant differences between groups A and B, the total number of strokes and myocardial infarcts being 28 in group A and 29 in group B.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed ID
7994450 View in PubMed
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Breast cancer and use of rauwolfia and other antihypertensive agents in hypertensive patients: a nationwide case-control study in Finland.

https://arctichealth.org/en/permalink/ahliterature250489
Source
Int J Cancer. 1976 Dec 15;18(6):727-38
Publication Type
Article
Date
Dec-15-1976
Author
A. Aromaa
M. Hakama
T. Hakulinen
E. Saxén
L. Teppo
J. Idä lan-Heikkilä
Source
Int J Cancer. 1976 Dec 15;18(6):727-38
Date
Dec-15-1976
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - adverse effects - therapeutic use
Breast Neoplasms - chemically induced - epidemiology
Carcinogens
Female
Finland
Humans
Hypertension - drug therapy
Insurance, Health
Middle Aged
Phytotherapy
Plants, Medicinal
Rauwolfia - adverse effects - therapeutic use
Registries
Risk
Abstract
Two nationwide registers, the Finnish Cancer Registry and a register of persons entitled to free drugs for hypertension, were linked in a case-control study of the association of breast cancer and use of rauwolfia. Cases were all hypertensive patients in whom breast cancer was diagnosed in 1973. To test the association specifically with rauwolfia, controls were hypertensive women matched with the cases for age and geographic area and approximately matched for duration of treatment for hypertension. There were 109 case-control pairs. Use of any physician-prescribed drugs during the year prior to diagnosis of breast cancer was ascertained from original prescriptions. In the first set of analyses the patients were classified according to the drug used during most days of the year ("main antihypertensive agent"). In the second set a person qualified as a user of the respective drug regardless of the amount taken. The relative risks in the use of rauwolfia, methyldopa, another synthetic antihypertensive or a diuretic as main antihypertensive agent all ranged between 0.90 and 1.11. The results based on use of a drug in any amount were similar. Next, pairs in which duration of treatment for hypertension was different for cases and controls were excluded. The relative risk associated with use of rauwolfia as main antihypertensive agent then increased from 1.00 to 1.30 and the risk associated with use of any amount of rauwolfia from 1.16 to 2.14. Simultaneously, the relative risk in the use of digitalis was raised from 1.33 to 2.67 and of nitroglycerin from 1.00 to 1.71. Cases also used more types of antihypertensive agents simultaneously than controls. There was no association between rauwolfia-use and breast cancer in analyses limited to pairs in which neither case nor control used digitalis. Thus, there was not a consistent drug-specific association between rauwolfia-use and breast cancer in hypertensive patients. An underlying association of hypertension, heart disease or its treatment (digitalis) and breast cancer may have confounded some of the results of this and earlier studies. In conclusion, it is unlikely that use of rauwolfia increases the risk of breast cancer.
PubMed ID
992904 View in PubMed
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Cardiovascular events in subgroups of patients during primary treatment of hypertension with candesartan or losartan.

https://arctichealth.org/en/permalink/ahliterature101819
Source
J Clin Hypertens (Greenwich). 2011 Mar;13(3):189-97
Publication Type
Article
Date
Mar-2011
Author
David Russell
Jan Stålhammar
Johan Bodegard
Pål Hasvold
Marcus Thuresson
Sverre E Kjeldsen
Author Affiliation
Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway. david.russell@medisin.uio.no
Source
J Clin Hypertens (Greenwich). 2011 Mar;13(3):189-97
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Aged
Antihypertensive Agents - adverse effects - therapeutic use
Benzimidazoles - adverse effects - therapeutic use
Blood pressure
Cardiovascular Diseases - epidemiology - etiology - prevention & control
Cardiovascular System - drug effects
Confidence Intervals
Female
Humans
Hypertension - drug therapy - epidemiology - mortality
Kaplan-Meier Estimate
Losartan - adverse effects - therapeutic use
Male
Middle Aged
Odds Ratio
Propensity Score
Risk assessment
Risk factors
Risk Reduction Behavior
Sweden - epidemiology
Tetrazoles - adverse effects - therapeutic use
Abstract
Merging data from existing electronic patient records, and electronic hospital discharge and cause of death registers, is a fast and relatively inexpensive method for comparing different treatments with regard to clinical outcome. This study compared the effects of antihypertensive treatment with candesartan or losartan on cardiovascular disease (CVD) using Swedish registers. Patients without previous CVD who were prescribed candesartan (n=7329) or losartan (n=6771) for hypertension during 1999-2007 at 72 Swedish primary care centers were followed for up to 9 years. Both medications were given according to current recommendations, and there was no difference observed in achieved blood pressures. The authors have previously shown that candesartan lowered the risk of all CVD (primary composite end point) more so than losartan (adjusted hazard ratio, 0.86; 95% confidence interval, 0.77-0.96). Candesartan also had a significantly better effect with regards to reducing the development of heart failure, cardiac arrhythmias, and peripheral arterial disease. In the present analysis, the authors found that candesartan, compared with losartan, reduced the risk of all CVD, irrespective of sex, age, previous antihypertensive treatment, baseline blood pressure, and presence of diabetes. These clinical findings may reflect differences between candesartan and losartan in their binding characteristics to the angiotensin type 1 receptor.
PubMed ID
21366850 View in PubMed
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Changes in maximal cardiorespiratory capacity among aging municipal employees.

https://arctichealth.org/en/permalink/ahliterature227556
Source
Scand J Work Environ Health. 1991;17 Suppl 1:99-109
Publication Type
Article
Date
1991
Author
J. Ilmarinen
V. Louhevaara
O. Korhonen
C H Nygård
T. Hakola
S. Suvanto
Author Affiliation
Institute of Occupational Health, Department of Physiology, Vantaa, Finland.
Source
Scand J Work Environ Health. 1991;17 Suppl 1:99-109
Date
1991
Language
English
Publication Type
Article
Keywords
Aging - physiology
Antihypertensive Agents - adverse effects - therapeutic use
Electrocardiography - drug effects
Exercise Test - drug effects
Female
Finland
Follow-Up Studies
Heart Rate - physiology
Humans
Hypertension - drug therapy - physiopathology
Leisure Activities
Local Government
Male
Middle Aged
Oxygen - blood
Physical Exertion - drug effects - physiology
Work Capacity Evaluation
Abstract
Before and after a four-year follow-up, maximal oxygen consumption (VO2max) was determined for 67 municipal employees (initial age about 51 years). The VO2max (ml.kg-1) decreased 6% among the women and increased 8% among the men, the greatest and smallest change occurring for employees doing mental and physical work, respectively. The men's increase was associated with an increase in leisure-time physical activity. Work content was not associated with the level of VO2max for either gender. After the four years the women's absolute VO2max was about 66% of the men's. There were marked changes in VO2max at the individual level, the most marked decreases being associated with the use of medication in some cases. After the four years the women's VO2max of 63% was insufficient according to current recommendations. Therefore physically demanding jobs are not generally recommended for older women.
PubMed ID
1792538 View in PubMed
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A cohort study of antihypertensive treatments and risk of renal cell cancer.

https://arctichealth.org/en/permalink/ahliterature17097
Source
Br J Cancer. 2005 Apr 11;92(7):1302-6
Publication Type
Article
Date
Apr-11-2005
Author
J P Fryzek
A H Poulsen
S P Johnsen
J K McLaughlin
H T Sørensen
S. Friis
Author Affiliation
International Epidemiology Institute, Rockville, MD 20850, USA. fryzek@aol.com
Source
Br J Cancer. 2005 Apr 11;92(7):1302-6
Date
Apr-11-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antihypertensive Agents - adverse effects - therapeutic use
Carcinoma, Renal Cell - epidemiology - etiology
Cohort Studies
Confounding Factors (Epidemiology)
Denmark - epidemiology
Female
Humans
Hypertension - complications - drug therapy
Kidney Neoplasms - epidemiology - etiology
Male
Middle Aged
Research Support, Non-U.S. Gov't
Risk factors
Abstract
We studied 335,682 county residents, of whom 113,298 had been prescribed antihypertensive treatment (AHT), in the period 1989-2002 in North Jutland County, Denmark to examine the relation between different AHTs and the risk of renal cell carcinoma (RCC). An internal comparison was performed among the different classes of AHT users with users of beta blockers as the reference, in order to address potential confounding and bias. The average follow-up was 10 years (range 0-13). Use of any AHT was associated with RCC (relative rate (RR)=1.6, 95% confidence interval (CI) 1.3-1.9) compared with nonusers in the general population. Specific classes of AHTs were nonsignificantly associated with RCC, but compared with users of beta blockers, the numbers observed were close to expectation. Analyses by duration of follow-up and number of prescriptions revealed no clear trends for any antihypertensive agent and after 5-years of follow-up, the RRs for all classes of AHT decreased. The elevated RRs for RCC among users of AHTs compared with the general population are unlikely to be causal, but rather reflect confounding due to failure to control for pre-existing hypertension, and protopathic bias, due to the presence of hypertension as an early sign of kidney disease.
PubMed ID
15812478 View in PubMed
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54 records – page 1 of 6.