Clinical InvestigationHypertensionCombination therapy as initial treatment for newly diagnosed hypertension
Section snippets
Definition of the hypertensive cohort
This study was conducted within the CVRN, a consortium of research organizations affiliated with the Health Maintenance Organization Research Network and sponsored by the National Heart, Lung, and Blood Institute. The CVRN Hypertension Registry includes all adult patients with hypertension at 3 large integrated health care delivery systems, HealthPartners of Minnesota, Kaiser Permanente Colorado, and Kaiser Permanente Northern California. The algorithm for entry into the cohort has been
Baseline characteristics of patients with incident hypertension
Among 161,585 patients with incident hypertension being initiated on therapy during the study period, there was a decline in the proportion of individuals entering the cohort with stage 2 hypertension (defined as initial SBP ≥160 mm Hg or DBP ≥100 mm Hg), from 58.7% in 2002 to 40.0% in 2007 (P < .001) (Figure 1). There was a corresponding decrease in SBP during the same period from a mean SBP of 158.1 mm Hg for those entering the cohort in 2002 to a mean of 152.3 mm Hg for those entering in
Discussion
The objectives of this study were to assess trends in the use of combination versus single-agent therapy as initial treatment for patients with incident hypertension and to evaluate the use of combination therapy and BP control. We found that initial therapy with 2 drugs for new-onset hypertension was associated with better BP control at 12 months compared with single-agent therapy even after adjusting for, among other factors, subsequent therapy intensification and medication adherence. The
Disclosures
Conflicts of Interest/Disclosure(s): P. M. H. serves as a consultant for Wellpoint, Inc.
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Cited by (0)
Sources of funding: This study was funded by grant U19HL091179 from the National Heart, Lung, and Blood Institute as part of the Cardiovascular Research Network. Dr Ho is supported by a Veterans Affairs Research & Development Career Development Award (05-026-2). Dr Byrd was supported by a Department of Veterans Affairs Cardiology Research Fellowship.