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Age‐specific differences in hypertension combination management and associated factors influencing treatment choice

The current hypertension guideline emphasizes combination therapy, especially single‐pill combination therapy (SPC). However, few studies compared the prevalence and factors associated with initial therapy choice across heterogeneous age groups in a current population. First, the authors consecutive...

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Autores principales: Xiong, Jianfei, Wang, Li, Yang, Chuanxi, Huang, Hengye, He, Ben, Shen, Lan, Su, Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246461/
https://www.ncbi.nlm.nih.gov/pubmed/37196052
http://dx.doi.org/10.1111/jch.14668
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author Xiong, Jianfei
Wang, Li
Yang, Chuanxi
Huang, Hengye
He, Ben
Shen, Lan
Su, Feng
author_facet Xiong, Jianfei
Wang, Li
Yang, Chuanxi
Huang, Hengye
He, Ben
Shen, Lan
Su, Feng
author_sort Xiong, Jianfei
collection PubMed
description The current hypertension guideline emphasizes combination therapy, especially single‐pill combination therapy (SPC). However, few studies compared the prevalence and factors associated with initial therapy choice across heterogeneous age groups in a current population. First, the authors consecutively identified 964 treatment naïve hypertensive patients in a large academic hospital from 01/31/2019 to 01/31/2020. All patients were grouped into (1) young aged, age < 55; (2) middle‐aged, 55≤age < 65; and (3) older aged, age ≥65. The multivariable regression model examined the factors associated with the combination therapy by age group. Overall, 80 (8.3%) were young, 191 (19.8%) were middle, and 693 (71.9%) were older aged. Compared with older age, younger patients were more likely to be male, highly educated, regularly exercised, have metabolic syndrome, and less likely to have cardiovascular‐related comorbidities, with a lower systolic but higher diastolic pressure. Only one in five patients used SPC, and the prevalence decreased with age. Besides hypertension grade, young patients without catheterization or echo test were less likely to receive multiple therapies, while older patients who were male with lower weight and lower risk levels were less likely to receive multiple therapies. In conclusion, combination therapy, especially SPC, was underused in the targeted hypertensive population. Our contemporary population study showed that young patients (<55) without a history of catheterization or echo examination and male older‐aged (≥65) patients with low‐risk classification were the population most likely to be neglected. Such information can help triage medical care resources in improving SPC use.
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spelling pubmed-102464612023-06-08 Age‐specific differences in hypertension combination management and associated factors influencing treatment choice Xiong, Jianfei Wang, Li Yang, Chuanxi Huang, Hengye He, Ben Shen, Lan Su, Feng J Clin Hypertens (Greenwich) Combination Therapy The current hypertension guideline emphasizes combination therapy, especially single‐pill combination therapy (SPC). However, few studies compared the prevalence and factors associated with initial therapy choice across heterogeneous age groups in a current population. First, the authors consecutively identified 964 treatment naïve hypertensive patients in a large academic hospital from 01/31/2019 to 01/31/2020. All patients were grouped into (1) young aged, age < 55; (2) middle‐aged, 55≤age < 65; and (3) older aged, age ≥65. The multivariable regression model examined the factors associated with the combination therapy by age group. Overall, 80 (8.3%) were young, 191 (19.8%) were middle, and 693 (71.9%) were older aged. Compared with older age, younger patients were more likely to be male, highly educated, regularly exercised, have metabolic syndrome, and less likely to have cardiovascular‐related comorbidities, with a lower systolic but higher diastolic pressure. Only one in five patients used SPC, and the prevalence decreased with age. Besides hypertension grade, young patients without catheterization or echo test were less likely to receive multiple therapies, while older patients who were male with lower weight and lower risk levels were less likely to receive multiple therapies. In conclusion, combination therapy, especially SPC, was underused in the targeted hypertensive population. Our contemporary population study showed that young patients (<55) without a history of catheterization or echo examination and male older‐aged (≥65) patients with low‐risk classification were the population most likely to be neglected. Such information can help triage medical care resources in improving SPC use. John Wiley and Sons Inc. 2023-05-17 /pmc/articles/PMC10246461/ /pubmed/37196052 http://dx.doi.org/10.1111/jch.14668 Text en © 2023 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Combination Therapy
Xiong, Jianfei
Wang, Li
Yang, Chuanxi
Huang, Hengye
He, Ben
Shen, Lan
Su, Feng
Age‐specific differences in hypertension combination management and associated factors influencing treatment choice
title Age‐specific differences in hypertension combination management and associated factors influencing treatment choice
title_full Age‐specific differences in hypertension combination management and associated factors influencing treatment choice
title_fullStr Age‐specific differences in hypertension combination management and associated factors influencing treatment choice
title_full_unstemmed Age‐specific differences in hypertension combination management and associated factors influencing treatment choice
title_short Age‐specific differences in hypertension combination management and associated factors influencing treatment choice
title_sort age‐specific differences in hypertension combination management and associated factors influencing treatment choice
topic Combination Therapy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246461/
https://www.ncbi.nlm.nih.gov/pubmed/37196052
http://dx.doi.org/10.1111/jch.14668
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