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Antihypertensive dr...
Antihypertensive drug effects on long-term blood pressure : an individual-level data meta-analysis of randomised clinical trials
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- Canoy, Dexter (author)
- Univ Oxford, Nuffield Dept Womens & Reprod Hlth, Deep Med, Oxford, England.;Oxford Univ Hosp NHS Fdn Trust, NIHR Oxford Biomed Res Ctr, Oxford, England.
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- Copland, Emma (author)
- Univ Oxford, Nuffield Dept Womens & Reprod Hlth, Deep Med, Oxford, England.
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- Nazarzadeh, Milad (author)
- Univ Oxford, Nuffield Dept Womens & Reprod Hlth, Deep Med, Oxford, England.
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- Ramakrishnan, Rema (author)
- Univ Oxford, Nuffield Dept Populat Hlth, Natl Perinatal Epidemiol Unit, Oxford, England.
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- Pinho-Gomes, Ana-Catarina (author)
- Kings Coll London, Fac Life Sci & Med, Sch Populat Hlth & Environm Sci, London, England.;Univ Porto, Ctr Hlth Technol & Serv Res, Dept Community Med, Porto, Portugal.
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- Salam, Abdul (author)
- Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia.;George Inst Global Hlth India, Hyderabad, India.
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- Dwyer, Jamie P. (author)
- Vanderbilt Univ, Med Ctr, Nashville, TN USA.
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- Farzadfar, Farshad (author)
- Univ Tehran Med Sci, Endocrinol & Metab Inst, Tehran, Iran.
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- Sundström, Johan, Professor, 1971- (author)
- Uppsala universitet,Klinisk epidemiologi
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- Woodward, Mark (author)
- Univ New South Wales, George Inst Global Hlth, Sydney, NSW, Australia.;Imperial Coll London, George Inst Global Hlth UK, London, England.
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- Davis, Barry R. (author)
- Univ Texas Houston, Dept Biostat, Sch Publ Hlth, Houston, TX USA.
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- Rahimi, Kazem (author)
- Univ Oxford, Nuffield Dept Womens & Reprod Hlth, Deep Med, Oxford, England.;Oxford Univ Hosp NHS Fdn Trust, NIHR Oxford Biomed Res Ctr, Oxford, England.
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Univ Oxford, Nuffield Dept Womens & Reprod Hlth, Deep Med, Oxford, England;Oxford Univ Hosp NHS Fdn Trust, NIHR Oxford Biomed Res Ctr, Oxford, England. Univ Oxford, Nuffield Dept Womens & Reprod Hlth, Deep Med, Oxford, England. (creator_code:org_t)
- 2022-01-20
- 2022
- English.
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In: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 108:16, s. 1281-1289
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Abstract
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- Objective: Evidence from randomised trials of pharmacological treatments on long-term blood pressure (BP) reduction is limited. We investigated the antihypertensive drug effects on BP over time and across different participant characteristics.Methods: We conducted an individual patient-level data meta-analysis of 52 large-scale randomised clinical trials in the Blood Pressure Lowering Treatment Trialists' Collaboration using mixed models to examine treatment effects on BP over 4 years of mean follow-up.Results: There were 363 684 participants (42% women), with baseline mean age=65 years and mean systolic/diastolic BP=152/87 mm Hg, and among whom 19% were current smokers, 49% had cardiovascular disease, 28% had diabetes and 69% were taking antihypertensive treatment at baseline. Drugs were effective in lowering BP showing maximal effect after 12 months and gradually attenuating towards later years. Based on measures taken >= 12 months postrandomisation, mean systolic/diastolic BP difference (95% CI) between more and less intense BP-lowering treatment was -11.1 (-11.3 to -10.8)/-5.6 (-5.7 to -5.4) mm Hg; between active treatment and placebo was -5.1 (-5.3 to -5.0)/-2.3 (-2.4 to -2.2) mm Hg; and between active and control arms for drug comparison trials was -1.4 (-1.5 to -1.3)/-0.6 (-0.7 to -0.6) mm Hg. BP reductions were observed across different baseline BP values and ages, and by sex, history of cardiovascular disease and diabetes and prior antihypertensive treatment use.Conclusion: These findings suggest that BP-lowering pharmacotherapy is effective in lowering BP, up to 4 years on average, in people with different characteristics. Appropriate treatment strategies are needed to sustain substantive long-term BP reductions.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- hypertension
- meta-analysis
- pharmacology
- clinical
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- ref (subject category)
- art (subject category)
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Heart
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Canoy, Dexter
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Copland, Emma
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Nazarzadeh, Mila ...
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Ramakrishnan, Re ...
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Pinho-Gomes, Ana ...
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Salam, Abdul
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Dwyer, Jamie P.
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Farzadfar, Farsh ...
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Sundström, Johan ...
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Woodward, Mark
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Davis, Barry R.
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Rahimi, Kazem
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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Heart
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Uppsala University