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Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis

It is not known whether serum potassium levels affect blood pressure response to anti-hypertensive medication. The African American trial of Kidney disease and Hypertension (AASK) Genomics Study (N=828) is a subset of the AASK trial that randomized 1,094 African American men and women with hypertens...

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Autores principales: Bhalla, Meeta, Aziz, Hossein, Richard, Erin, Lipkowitz, Michael S., Bhatnagar, Vibha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4537064/
https://www.ncbi.nlm.nih.gov/pubmed/23151750
http://dx.doi.org/10.1038/jhh.2012.47
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author Bhalla, Meeta
Aziz, Hossein
Richard, Erin
Lipkowitz, Michael S.
Bhatnagar, Vibha
author_facet Bhalla, Meeta
Aziz, Hossein
Richard, Erin
Lipkowitz, Michael S.
Bhatnagar, Vibha
author_sort Bhalla, Meeta
collection PubMed
description It is not known whether serum potassium levels affect blood pressure response to anti-hypertensive medication. The African American trial of Kidney disease and Hypertension (AASK) Genomics Study (N=828) is a subset of the AASK trial that randomized 1,094 African American men and women with hypertensive nephrosclerosis to ramipril, amlodipine or metoprolol. Participants were also randomized to a usual (102–107 mmHg) or low (≤92 mmHg) mean arterial pressure (MAP) treatment goal. Time-to-event analyses were used to determine the relationship between serum potassium prior to randomization and time (days) to reach an MAP of 107 mmHg. Mean baseline serum potassium was 4.22 (standard deviation +/− 0.56 and range 2.8–6.0) mmol/L and the median days to reach target MAP was 32 (interquartile range 8–95) days. The adjusted hazard ratio (HR) for each 1mmol/L increase in serum potassium was 1.31 (95%CI: 1.08–1.59) in the usual MAP group, and 1.21 (95%CI: 1.02–1.44) in the low MAP group. Secondary findings suggested that women in the usual MAP group on amlodipine were more likely to reach target MAP compared to women randomized to ramipril (HR: 2.05, 95%CI: 1.30–3.21). Older subjects in the low MAP group (≥55 years) were also more likely to reach target MAP on amlodipine compared to ramipril (HR: 1.57, 95%CI: 1.03–2.38). Serum potassium appears to be a significant predictor of time to blood pressure response, independent of drug class. Results also suggest a benefit of using amlodipine when more rapid blood pressure control is clinically indicated among women and more aggressively managed older subjects.
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spelling pubmed-45370642015-08-14 Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis Bhalla, Meeta Aziz, Hossein Richard, Erin Lipkowitz, Michael S. Bhatnagar, Vibha J Hum Hypertens Article It is not known whether serum potassium levels affect blood pressure response to anti-hypertensive medication. The African American trial of Kidney disease and Hypertension (AASK) Genomics Study (N=828) is a subset of the AASK trial that randomized 1,094 African American men and women with hypertensive nephrosclerosis to ramipril, amlodipine or metoprolol. Participants were also randomized to a usual (102–107 mmHg) or low (≤92 mmHg) mean arterial pressure (MAP) treatment goal. Time-to-event analyses were used to determine the relationship between serum potassium prior to randomization and time (days) to reach an MAP of 107 mmHg. Mean baseline serum potassium was 4.22 (standard deviation +/− 0.56 and range 2.8–6.0) mmol/L and the median days to reach target MAP was 32 (interquartile range 8–95) days. The adjusted hazard ratio (HR) for each 1mmol/L increase in serum potassium was 1.31 (95%CI: 1.08–1.59) in the usual MAP group, and 1.21 (95%CI: 1.02–1.44) in the low MAP group. Secondary findings suggested that women in the usual MAP group on amlodipine were more likely to reach target MAP compared to women randomized to ramipril (HR: 2.05, 95%CI: 1.30–3.21). Older subjects in the low MAP group (≥55 years) were also more likely to reach target MAP on amlodipine compared to ramipril (HR: 1.57, 95%CI: 1.03–2.38). Serum potassium appears to be a significant predictor of time to blood pressure response, independent of drug class. Results also suggest a benefit of using amlodipine when more rapid blood pressure control is clinically indicated among women and more aggressively managed older subjects. 2012-11-15 2013-06 /pmc/articles/PMC4537064/ /pubmed/23151750 http://dx.doi.org/10.1038/jhh.2012.47 Text en Users may view, print, copy, download and text and data- mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms
spellingShingle Article
Bhalla, Meeta
Aziz, Hossein
Richard, Erin
Lipkowitz, Michael S.
Bhatnagar, Vibha
Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis
title Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis
title_full Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis
title_fullStr Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis
title_full_unstemmed Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis
title_short Serum Potassium Predicts Time to Blood Pressure Response Among African-Americans with Hypertensive Nephrosclerosis
title_sort serum potassium predicts time to blood pressure response among african-americans with hypertensive nephrosclerosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4537064/
https://www.ncbi.nlm.nih.gov/pubmed/23151750
http://dx.doi.org/10.1038/jhh.2012.47
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