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Träfflista för sökning "WFRF:(Kahan T) ;pers:(Schiöler Linus 1977)"

Sökning: WFRF:(Kahan T) > Schiöler Linus 1977

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1.
  • Bokrantz, Tove, et al. (författare)
  • 7b.10: Thiazide Diuretics and Fracture-Risk among Hypertensive Patients. Results from the Swedish Primary Care Cardiovascular Database (Spccd)
  • 2015
  • Ingår i: Journal of hypertension. - : Ovid Technologies (Wolters Kluwer Health). - 0263-6352 .- 1473-5598. ; 33 Suppl 1, s. e94-5
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • OBJECTIVE: To investigate whether treatment with thiazide diuretics reduces the risk of osteoporotic fractures in hypertensive patients in primary health care. Further we aimed to examine the impact of duration of thiazide use, the consequences of discontinuation of use and effect-modifications by gender. DESIGN AND METHOD: This retrospective cohort study includes 60 893 individuals, diagnosed with hypertension during 2001-2008 included in the Swedish Primary Care Cardiovascular Database. All patients were followed from a fixed baseline (1 Jan 2006, or the date the patient received their first diagnosis of hypertension if that date came later) until they had an incident osteoporotic fracture, died, or reached the end of the study at 31 Dec 2012, whichever came first. Patients exposed to thiazide diuretics (dispensed drugs recorded through the Prescribed Drug Register) were compared with hypertensive patients never exposed to thiazides. RESULTS: During follow up 2421 osteoporotic fractures occurred. Current use of thiazide diuretics was found to be associated with significantly reduced risk of osteoporotic fractures (adjusted hazard ratios 0.88; 95% CI 0.81-0.97) independent of blood pressure level. In addition, risk appeared to decline with longer duration of use. In contrast, discontinuation of dispensed prescriptions of thiazides was associated with increased risk of osteoporotic fractures (HR 1.17; 95% CI 1.04-1.31).However, a trend towards attenuation of the increased risk with longer duration past treatment period was seen. When analyzing men and women separately similar results were seen, for both genders, although only statistically significant for men. CONCLUSIONS: In this large retrospective cohort study of hypertensive men and women from Sweden, we could identity a protective effect on osteoporotic fractures among current users of thiazide diuretic drugs independent of blood pressure level. However, the risk of fracture was found to be increased in patients shortly after discontinuation of treatment compared to patients never prescribed thiazide diuretic drugs. The reason for an augmented outcome on osteoporotic fractures among patients with former thiazide diuretic therapy needs to be further elucidated.
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2.
  • Holmqvist, Lina, et al. (författare)
  • Drug adherence in treatment resistant and in controlled hypertension - Results from the Swedish Primary Care Cardiovascular Database (SPCCD)
  • 2018
  • Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 27:3, s. 315-321
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To assess drug adherence in patients treated with 3 antihypertensive drug classes, with both controlled and uncontrolled blood pressure and describe associated factors for nonadherence. Methods Patients with hypertension, without cardiovascular comorbidity, aged >30years treated with 3 antihypertensive drug classes were followed for 2years. Both patients with treatment resistant hypertension (TRH) and patients with controlled hypertension were included. Clinical data were derived from a primary care database. Pharmacy refill data from the Swedish Prescribed drug registry was used to calculate proportion of days covered (PDC). Patients with a PDC level80% were included. Results We found 5846 patients treated 3 antihypertensive drug classes, 3508 with TRH (blood pressure140/90), and 2338 with controlled blood pressure (<140/90mmHg). TRH patients were older (69.1 vs 65.8years, P<.0001) but had less diabetes (28.5 vs 31.7%, P<.009) compared with patients with controlled blood pressure. The proportion of patients with PDC80% declined with 11% during the first year in both groups. Having diabetes was associated with staying adherent at 1year (RR 0.82; 95% CI, 0.68-0.98) whilst being born outside Europe was associated with nonadherence at one and (RR 2.05; 95% CI, 1.49-2.82). ConclusionsPatients with multiple antihypertensive drug therapy had similar decline in adherence over time regardless of initial blood pressure control. Diabetes was associated with better adherence, which may imply that the structured caregiving of these patients enhances antihypertensive drug treatment.
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3.
  • Ljungman, Charlotta, 1977, et al. (författare)
  • 7b.02: The Association between Non-Steroidal Anti-Inflammatory Drugs and Blood Pressure Control in Hypertensive Patients and the Relation to Gender
  • 2015
  • Ingår i: Journal of hypertension. - : Ovid Technologies (Wolters Kluwer Health). - 0263-6352 .- 1473-5598. ; 33 Suppl 1
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • OBJECTIVE: Approximately 25% of hypertensive patients >65 years are treated for arthrosis, which is the most common cause of long term use of non-steroidal anti-inflammatory drugs (NSAID). NSAID inhibits prostaglandin synthesis and interacts with the renin angiotensin system. The objective of this study was to investigate if concomitant use of NSAID in hypertensive patients is associated with a lower possibility to reach target blood pressure <140/90 mm Hg, and to elucidate if there are gender differences regarding this matter.(Figure is included in full-text article.) DESIGN AND METHOD: : This cross-sectional cohort study includes 40825 patients with hypertension from the Swedish primary Care Cardiovascular Database (SPCCD) in 2007-2008. Patient characteristics, antihypertensive drug class, dispensations of NSAIDs, comorbidities and blood pressure measurements were analyzed. The proportion of days covered (PDC) with prescription was calculated in order to analyze the NSAID use and the PDC was grouped <50%, 50-80% and >80% of days covered with prescription during 180 days prior to the last blood pressure measurement. RESULTS: In all 6700 patients had at least one prescription of NSAID. Patients with NSAID were younger (67.9 +/- 11.2 vs 69.4 +/- 11.9 years, p < 0.0001), and more often female (63.2 vs 56.3%, p < 0.0001) with a diagnosis of musculoskeletal disease (20.8 vs 12.8%, p < 0.0001 and with no cardiovascular comorbidity (26.5 vs 32.1%, p < 0.0001). There was no difference in SBP between patients with and without NSAID (142 +/- 16, 142 +/- 17 mmHg respectively, ns). Patients with NSAID had a higher DBP (80 +/- 10, 79 +/- 10 mmHg, respectively p < 0.001). In a logistic regression model adjusted for age, smoking, cardiovascular comorbidity, antihypertensive drug class, education, and country of birth there was no difference in the proportion achieving target blood pressure in patients with and without concomitant use of NSAID irrespective of the PDC for NSAID users (figure 1). The results were similar in both genders. CONCLUSIONS: Concomitant use of NSAID in hypertensive patients does not seem to be associated with a higher blood pressure level. The use of NSAIDs is not associated with a reduced ability of achieving target blood pressure. Thus, hypertensive patients do not a priori need to be discouraged to use NSAID.
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4.
  • Ljungman, Charlotta, 1977, et al. (författare)
  • Antihypertensive treatment and control according to gender, education, country of birth and psychiatric disorder: the Swedish Primary Care Cardiovascular Database (SPCCD)
  • 2015
  • Ingår i: Journal of Human Hypertension. - : Springer Science and Business Media LLC. - 0950-9240 .- 1476-5527. ; 29
  • Tidskriftsartikel (refereegranskat)abstract
    • The reasons why women and men are treated with different antihypertensive drugs are not clear. Whether socioeconomic factors influence prescription patterns and blood pressure control differently in women and men has not been investigated. This cross-sectional study performed in a cohort of hypertensive patients from the Swedish Primary Care Cardiovascular Database (SPCCD) examined the influence of educational level, country of birth, gender and concomitant psychiatric disorder on prescription pattern and blood pressure control in 40 825 hypertensive patients. Men were more often than women treated with calcium channel blocker and angiotensin-converting enzyme inhibitor (ACEI), irrespective of education, country of birth and psychiatric disorder. Educational level influenced the prescription pattern to some extent, where the gender differences were reduced in patients with a higher educational level. In women, but not in men, high educational level and concomitant psychiatric disorder were associated with a higher proportion reaching target blood pressure. The predominant use of ACEI and calcium channel blockers in men is not influenced by educational level, country of birth or psychiatric disorder. Thus other explanations must be considered such as gender differences in side effects. Educational level seems to have a greater impact on reaching target blood pressure in women compared with men.Journal of Human Hypertension advance online publication, 6 November 2014; doi:10.1038/jhh.2014.100.
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6.
  • Mourtzinis, Georgios, 1974, et al. (författare)
  • Relation Between Lipid Profile and New-Onset Atrial Fibrillation in Patients With Systemic Hypertension (From the Swedish Primary Care Cardiovascular Database SPCCD )
  • 2018
  • Ingår i: American Journal of Cardiology. - : Elsevier BV. - 0002-9149 .- 1879-1913. ; 122:1, s. 102-107
  • Tidskriftsartikel (refereegranskat)abstract
    • The relation between dyslipidemia and atrial fibrillation (AF) development is still controversial. To assess the impact of lipid profile on new-onset AF, we followed 51,020 primary-care hypertensive patients without AF at baseline. After a mean follow-up time of 3.5 years, AF occurred in 2,389 participants (4.7%). We evaluated the association between total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and new-onset AF. In a Poisson regression model fully adjusted for common risk factors of AF, we found that 1.0 mmol/l (39 mg/dl) increase in total cholesterol was associated with 19% lower risk of new-onset AF (95% confidence interval [CI] 9% to 28%), and 1.0 mmol/l (39 mg/dl) increase in low-density lipoprotein cholesterol was associated with 16% lower risk of new-onset AF (95% CI 3% to 27%). Gender-specific Poisson regression analyses revealed that increase in total cholesterol by 1.0 mmol/l (39 mg/ dl) was found to be associated with lower risk of new-onset AF with 21% in men (95% CI 8% to 32%), and 18% in women (95% CI 1% to 31%). There was no association between high-density lipoprotein cholesterol or triglycerides and new-onset AF, neither in the whole population with respect to separate gender. In conclusion, in a large hypertensive population we found an inverse association between total cholesterol and new-onset AF for both men and women. Our results confirm previous reports of a dyslipidemia paradox, and extend these observations to the hypertensive population. (C) 2018 Elsevier Inc. All rights reserved. (Am J Cardiol 2018;122:102-107)
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