Cargando…

Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease

Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) are recommended in the treatment of arterial hypertension in patients with peripheral arterial disease (PAD). The aims of our study were: (a) to analyse the extent of reinitiation and subsequent discontinuation...

Descripción completa

Detalles Bibliográficos
Autores principales: Wawruch, Martin, Murin, Jan, Tesar, Tomas, Petrova, Miriam, Paduchova, Martina, Celovska, Denisa, Havelkova, Beata, Trnka, Michal, Masarykova, Lucia, Alfian, Sofa D., Aarnio, Emma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953445/
https://www.ncbi.nlm.nih.gov/pubmed/36830904
http://dx.doi.org/10.3390/biomedicines11020368
_version_ 1784893879566204928
author Wawruch, Martin
Murin, Jan
Tesar, Tomas
Petrova, Miriam
Paduchova, Martina
Celovska, Denisa
Havelkova, Beata
Trnka, Michal
Masarykova, Lucia
Alfian, Sofa D.
Aarnio, Emma
author_facet Wawruch, Martin
Murin, Jan
Tesar, Tomas
Petrova, Miriam
Paduchova, Martina
Celovska, Denisa
Havelkova, Beata
Trnka, Michal
Masarykova, Lucia
Alfian, Sofa D.
Aarnio, Emma
author_sort Wawruch, Martin
collection PubMed
description Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) are recommended in the treatment of arterial hypertension in patients with peripheral arterial disease (PAD). The aims of our study were: (a) to analyse the extent of reinitiation and subsequent discontinuation in older hypertensive PAD patients non-persistent with ACEIs/ARBs; (b) to determine patient and medication factors associated with reinitiation and subsequent discontinuation; and (c) to compare these factors between prevalent and new users. The analysis of reinitiation was performed on a sample of 1642 non-persistent patients aged ≥65 years with PAD newly diagnosed in 2012. Patients reinitiating ACEIs/ARBs were used for the analysis of subsequent discontinuation identified according to the treatment gap period of at least 6 months without any prescription of ACEI/ARB. In the group of non-persistent patients, 875 (53.3%) patients reinitiated ACEIs/ARBs during a follow-up (24.8 months on average). Within this group, subsequent discontinuation was identified in 414 (47.3%) patients. Being a new user was associated with subsequent discontinuation, but not with reinitiation. Myocardial infarction during non-persistence and after reinitiation was associated with reinitiation and lower likelihood of subsequent discontinuation, respectively. Being a prevalent or a new user is associated with the use of medication also after initial discontinuation.
format Online
Article
Text
id pubmed-9953445
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99534452023-02-25 Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease Wawruch, Martin Murin, Jan Tesar, Tomas Petrova, Miriam Paduchova, Martina Celovska, Denisa Havelkova, Beata Trnka, Michal Masarykova, Lucia Alfian, Sofa D. Aarnio, Emma Biomedicines Article Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) are recommended in the treatment of arterial hypertension in patients with peripheral arterial disease (PAD). The aims of our study were: (a) to analyse the extent of reinitiation and subsequent discontinuation in older hypertensive PAD patients non-persistent with ACEIs/ARBs; (b) to determine patient and medication factors associated with reinitiation and subsequent discontinuation; and (c) to compare these factors between prevalent and new users. The analysis of reinitiation was performed on a sample of 1642 non-persistent patients aged ≥65 years with PAD newly diagnosed in 2012. Patients reinitiating ACEIs/ARBs were used for the analysis of subsequent discontinuation identified according to the treatment gap period of at least 6 months without any prescription of ACEI/ARB. In the group of non-persistent patients, 875 (53.3%) patients reinitiated ACEIs/ARBs during a follow-up (24.8 months on average). Within this group, subsequent discontinuation was identified in 414 (47.3%) patients. Being a new user was associated with subsequent discontinuation, but not with reinitiation. Myocardial infarction during non-persistence and after reinitiation was associated with reinitiation and lower likelihood of subsequent discontinuation, respectively. Being a prevalent or a new user is associated with the use of medication also after initial discontinuation. MDPI 2023-01-26 /pmc/articles/PMC9953445/ /pubmed/36830904 http://dx.doi.org/10.3390/biomedicines11020368 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wawruch, Martin
Murin, Jan
Tesar, Tomas
Petrova, Miriam
Paduchova, Martina
Celovska, Denisa
Havelkova, Beata
Trnka, Michal
Masarykova, Lucia
Alfian, Sofa D.
Aarnio, Emma
Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease
title Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease
title_full Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease
title_fullStr Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease
title_full_unstemmed Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease
title_short Reinitiation and Subsequent Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers among New and Prevalent Users Aged 65 Years or More with Peripheral Arterial Disease
title_sort reinitiation and subsequent discontinuation of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers among new and prevalent users aged 65 years or more with peripheral arterial disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953445/
https://www.ncbi.nlm.nih.gov/pubmed/36830904
http://dx.doi.org/10.3390/biomedicines11020368
work_keys_str_mv AT wawruchmartin reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT murinjan reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT tesartomas reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT petrovamiriam reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT paduchovamartina reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT celovskadenisa reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT havelkovabeata reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT trnkamichal reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT masarykovalucia reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT alfiansofad reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease
AT aarnioemma reinitiationandsubsequentdiscontinuationofangiotensinconvertingenzymeinhibitorsandangiotensinreceptorblockersamongnewandprevalentusersaged65yearsormorewithperipheralarterialdisease