BACKGROUND:Hypertension affects 1 billion individuals worldwide and is an independent risk factor for death after acute coronary syndromes (ACS). METHODS: We examined the prevalence and medical treatment of hypertension among 15,904 ACS patients randomized in the SYMPHONY and 2nd SYMPHONY trials. Analyses were performed overall and according to sex for the United States and across international practice. Multivariable models identified factors associated with use of antihypertensive medication classes and examined the association of hypertension and sex with mortality. RESULTS: In the United States, hypertension was more prevalent in women than in men, overall (63% vs 50%) and within every decile of age. Hypertensive women more often received calcium-channel blockers (35% vs 30%) and diuretics (33% vs 19%) and less often received beta-blockers (51% vs 57%). Angiotensin-converting enzyme inhibitor use was similar (35% vs 34%). Women received multiple agents more frequently than did men: 2 agents, 35% vs 30%; > or = 3 agents, 16% vs 13%. Female sex independently predicted drug-class use only for diuretics. Mortality was higher in hypertensive women than in hypertensive men; after multivariable adjustment, mortality was similar without evidence of a differential association between hypertension and mortality according to sex. Although there was international variation in the use of individual classes of agents, the overall findings by sex were similar across regions. CONCLUSION:Hypertension is more prevalent in women than in men with ACS, and its medical management varies by sex, but its association with mortality is similar. Opportunities exist to improve medical therapy and outcomes in women with hypertension.
RCT Entities:
BACKGROUND:Hypertension affects 1 billion individuals worldwide and is an independent risk factor for death after acute coronary syndromes (ACS). METHODS: We examined the prevalence and medical treatment of hypertension among 15,904 ACS patients randomized in the SYMPHONY and 2nd SYMPHONY trials. Analyses were performed overall and according to sex for the United States and across international practice. Multivariable models identified factors associated with use of antihypertensive medication classes and examined the association of hypertension and sex with mortality. RESULTS: In the United States, hypertension was more prevalent in women than in men, overall (63% vs 50%) and within every decile of age. Hypertensivewomen more often received calcium-channel blockers (35% vs 30%) and diuretics (33% vs 19%) and less often received beta-blockers (51% vs 57%). Angiotensin-converting enzyme inhibitor use was similar (35% vs 34%). Women received multiple agents more frequently than did men: 2 agents, 35% vs 30%; > or = 3 agents, 16% vs 13%. Female sex independently predicted drug-class use only for diuretics. Mortality was higher in hypertensivewomen than in hypertensivemen; after multivariable adjustment, mortality was similar without evidence of a differential association between hypertension and mortality according to sex. Although there was international variation in the use of individual classes of agents, the overall findings by sex were similar across regions. CONCLUSION:Hypertension is more prevalent in women than in men with ACS, and its medical management varies by sex, but its association with mortality is similar. Opportunities exist to improve medical therapy and outcomes in women with hypertension.
Authors: Emanuele Cecchi; Maria Grazia D'Alfonso; Marco Chiostri; Elena Parigi; Daniele Landi; Serafina Valente; Salvatore Mario Romano; Gian Franco Gensini; Cristina Giglioli Journal: High Blood Press Cardiovasc Prev Date: 2013-11-12
Authors: Faye S Routledge; Alan L Hinderliter; James A Blumenthal; Andrew Sherwood Journal: J Clin Hypertens (Greenwich) Date: 2012-03-05 Impact factor: 3.738
Authors: Farah Yasmin; Sumeet Kumar; Manjeet Singh; Karan Kumar; Om Parkash; Muhammad Sohaib Asghar; Fareeha Jawed; Tooba Ahmed Kirmani; Muhammad Tanveer Alam Journal: Ann Med Surg (Lond) Date: 2022-04-01
Authors: Hyukjin Park; Young Joon Hong; Jae Yeong Cho; Doo Sun Sim; Hyun Ju Yoon; Kye Hun Kim; Ju Han Kim; Youngkeun Ahn; Myung Ho Jeong; Jeong Gwan Cho; Jong Chun Park Journal: Korean Circ J Date: 2017-07-12 Impact factor: 3.243