Effects of Noncardiovascular Comorbidities on Antihypertensive Use in Elderly Hypertensives

@article{Wang2005EffectsON,
  title={Effects of Noncardiovascular Comorbidities on Antihypertensive Use in Elderly Hypertensives},
  author={Philip S. Wang and Jerry Avorn and M. Alan Brookhart and Helen Mogun and Sebastian Schneeweiss and Michael A. Fischer and Robert J. Glynn},
  journal={Hypertension},
  year={2005},
  volume={46},
  pages={273-279}
}
Although the benefits of antihypertensive drugs have been clearly established, they remain underused by vulnerable older populations. We examined whether the presence of noncardiovascular comorbidity deters use of antihypertensives in elderly with hypertension. We conducted a retrospective cohort study among 51 517 patients ≥65 years of age in the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE) Program during 1999 and 2000. All were hypertensive and had diagnoses and used… 

Figures and Tables from this paper

Impact of Hospitalization on Antihypertensive Pharmacotherapy among Older Persons

Two out of every five older persons on antihypertensive medications will experience changes to their regimens during admission to hospital with most changes in anti Hypertensive pharmacotherapy due to adverse drug reactions.

Differential Effects of Comorbidity on Antihypertensive and Glucose-Regulating Treatment in Diabetes Mellitus – A Cohort Study

Diabetes-related comorbidity induced better risk factor treatment only for incident cases, implying that appropriate care is provided more often when complications occur, and the observed “undertreatment” in diabetes care cannot be explained by constraints caused by such comorbridity.

Kidney function and use of recommended medications after myocardial infarction in elderly patients.

Differences in other characteristics such as age, rather than kidney function, may be responsible for much or all the reported reduction in use of preventive medications after MI seen in patients with chronic kidney disease.

University of Groningen Differential effects of comorbidity on antihypertensive and glucose-regulating treatment in diabetes mellitus Voorham,

Diabetes-related comorbidity induced better risk factor treatment only for incident cases, implying that appropriate care is provided more often when complications occur, and the observed ‘‘undertreatment’’ in diabetes care cannot be explained by constraints caused by such comor bidity.

Compliance with Antihypertensive Therapy in the Elderly

  • M. DicksonC. Plauschinat
  • Medicine
    American journal of cardiovascular drugs : drugs, devices, and other interventions
  • 2008
Use of fixed-dose amlodipine besylate/benazepril HCl by elderly Medicaid recipients was associated with improved compliance and lower healthcare costs compared with a dihydropyridine calcium channel antagonist and ACE inhibitor prescribed as separate agents.

Chronic obstructive pulmonary disease and cardiovascular mortality in elderly subjects from general population

Pulse pressure was directly related and anti-hypertensive therapy inversely related to risk of CV mortality, an association that was greater in subjects with than without COPD, and COPD should be included in the computation of global risk in HT subjects.

Comorbidities of patients with hypertension admitted to emergency departments in Florida hospitals.

The objective was to compare the characteristics, comorbidities and symptoms among patients with three types (unspecified, benign, or malignant) of EHT in Florida.

Noncardiovascular illness as barrier to antihypertensive treatment.

Control rates of hypertension vary from one country to another, but in general, they are much lower than would be desirable and the fractions of hypertensive patients with properly controlled blood pressure range from ≈5% to 45%.

Continuity of Care and Its Effect on Prescription Drug Use Among Medicare Beneficiaries With Hypertension

There was no clear evidence that Medicare beneficiaries with greater continuity of care had increased adherence to antihypertensive drugs for most variables studied.

Does depressed persons with non-cardiovascular morbidity have a higher risk of CVD? A population-based cohort study in Sweden

Persons affected by depression in combination with non-card cardiovascular morbidity had a higher risk of CVD compared to those without non- Cardiovascular morbidity or depression alone.
...

References

SHOWING 1-10 OF 172 REFERENCES

Initiation of antihypertensive treatment during nonsteroidal anti-inflammatory drug therapy.

Use of NSAIDs may increase the risk for initiation of antihypertensive therapy in older persons given the high prevalence of NSAID use by elderly persons, and this association may have important public health implications for the management of hypertension in the older population.

Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race.

Despite the efficacy of antihypertensive therapy in preventing cardiovascular morbidity, such high rates of noncompliance may contribute to suboptimal patient outcomes.

Quality of medical care and excess mortality in older patients with mental disorders.

Deficits in quality of medical care seemed to explain a substantial portion of the excess mortality experienced by patients with mental disorders after myocardial infarction, and the potential importance of improving patients' medical care as a step toward reducing their excess mortality is suggested.

Noncompliance with antihypertensive medications

Interestingly, patient knowledge of hypertension, health beliefs, satisfaction with care, and other psychosocial variables did not appear to consistently affect adherence to prescribed regimens, and depression was significantly associated with noncompliance.

Treatment of hypertensive patients with coexisting coronary arterial disease

Thiazide diuretics have proven themselves effective again in the ALLHAT study and are likely to be an integral part of treatment for the great majority of patients with coronary artery disease.

A comparison of outcomes with angiotensin-converting--enzyme inhibitors and diuretics for hypertension in the elderly.

Initiation of antihypertensive treatment involving ACE inhibitors in older subjects, particularly men, appears to lead to better outcomes than treatment with diuretic agents, despite similar reductions of blood pressure.

Do Nonsteroidal Anti-inflammatory Drugs Affect Blood Pressure? A Meta-Analysis

A stable estimate of the overall effect of various NSAIDs on blood pressure is produced to evaluate possible mechanisms by which NSAID therapy may alter blood pressure and to determine potential predisposing factors for this interaction.

Cardiovascular Outcomes in the Irbesartan Diabetic Nephropathy Trial of Patients with Type 2 Diabetes and Overt Nephropathy

The analysis of the cardiovascular end points that were monitored as secondary end points in the Irbesartan Diabetic Nephropathy Trial (IDNT) was reported to assess whether an angiotensin II receptor blocker or a calcium-channel blocker alters the risk for cardiovascular events beyond those observed by blood pressure reduction alone without such agents.
...