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Hierarchical modeling of blood pressure determinants and outcomes following valsartan treatment in hypertensive patients with known comorbidities: pooled analysis of six prospective real-world studies including 11,999 patients

Alkhatib, Nimer and Sun, Diana and Denhaerynck, Kris and Hamarneh, Dina and Van Camp, Yoleen and Villa, Lorenzo and Brié, Heidi and Vancayzeele, Stefaan and MacDonald, Karen and Abraham, Ivo. (2021) Hierarchical modeling of blood pressure determinants and outcomes following valsartan treatment in hypertensive patients with known comorbidities: pooled analysis of six prospective real-world studies including 11,999 patients. Current medical research and opinion, 37 (1). pp. 1-8.

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Official URL: https://edoc.unibas.ch/79454/

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Abstract

Six prospective real-world studies of antihypertensive treatment with valsartan-centric regimens were pooled to (1) examine the effectiveness of ∼90 days of second- or later-line valsartan treatment in hypertensive patients with known comorbidities; and (2) identify physician and patient-related determinants associated with systolic (SBP) and diastolic blood pressure (DBP) outcomes in these patients.; Pooled analysis of an evaluable sample of 11,999 hypertensive patients with known comorbidities treated ∼90 days with valsartan-centric regimens. We applied hierarchical linear and logistic regression models to identify determinants of blood pressure (BP) outcomes and a potential physician class effect.; Valsartan regimens resulted in mean(SD) systolic (SBP) and diastolic (DBP) reductions of 18.0(15.8)mmHg and 9.5(10.1)mmHg, respectively, at ∼90 days; yielding SBP, DBP and combined SBP/DBP control rates of 44.0%, 67.2% and 39.3%, respectively. About a quarter of the variance in 90-day BP values was attributable to a physician class effect. BP outcomes declined with physicians' increasing years in practice and being male. At the patient-level, BP outcomes declined with SBP and DBP at diagnosis; diabetes; higher cholesterol and BMI; lower valsartan and HCTZ doses; and concomitant anti-hypertensives. Older age was associated with improved DBP. A proxy of physician vigilance, cardiovascular disease history was associated with improved BP outcomes; as were patient adherence and higher doses of valsartan in combination with HCTZ.; Valsartan-centric regimens have significant BP lowering benefits in this pooled sample of patients with known comorbidities. Many observed determinants of BP outcomes are modifiable or manageable.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Institut für Pflegewissenschaft
UniBasel Contributors:Denhaerynck, Kris
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Taylor & Francis
ISSN:0300-7995
e-ISSN:1473-4877
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:22 Mar 2021 10:50
Deposited On:22 Mar 2021 10:50

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