Stephanie K Tanamas1, Robert L Hanson2, Robert G Nelson3, William C Knowler4. 1. National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ. Electronic address: stephanie.tanamas@nih.gov. 2. National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ. Electronic address: rhanson@phx.niddk.nih.gov. 3. National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ. Electronic address: rnelson@phx.niddk.nih.gov. 4. National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ. Electronic address: wknowler@phx.niddk.nih.gov.
Abstract
BACKGROUND: Underlying blood pressure is that observed in the absence of antihypertensive treatment or, among those treated, the estimate of that which would be observed without treatment. This study aims to examine the relationships between diabetes or obesity and underlying systolic blood pressure adjusted for antihypertensive treatment by several methods. METHODS: Data from two population studies were analyzed-an American Indian community in Arizona and the National Health and Nutrition Examination Surveys. Antihypertensive treatment was accounted for using: no adjustment; antihypertensive use as a covariate; blood pressure dichotomized into normotension and hypertension; addition of a fixed treatment effect; non-parametric algorithm; and censored normal regression. RESULTS: The magnitude of association at each time point differed by adjustment method particularly where there was a difference in prevalence of antihypertensive use between people with and without diabetes or obesity. The common methods of ignoring antihypertensive treatment or including it as a covariate in a regression model underestimated the effects of diabetes and obesity on underlying blood pressure, compared to the recommended method of the censored normal regression. CONCLUSION: Proper accounting for antihypertensive treatment is needed in interpreting variables that affect blood pressure. Published by Elsevier Inc.
BACKGROUND: Underlying blood pressure is that observed in the absence of antihypertensive treatment or, among those treated, the estimate of that which would be observed without treatment. This study aims to examine the relationships between diabetes or obesity and underlying systolic blood pressure adjusted for antihypertensive treatment by several methods. METHODS: Data from two population studies were analyzed-an American Indian community in Arizona and the National Health and Nutrition Examination Surveys. Antihypertensive treatment was accounted for using: no adjustment; antihypertensive use as a covariate; blood pressure dichotomized into normotension and hypertension; addition of a fixed treatment effect; non-parametric algorithm; and censored normal regression. RESULTS: The magnitude of association at each time point differed by adjustment method particularly where there was a difference in prevalence of antihypertensive use between people with and without diabetes or obesity. The common methods of ignoring antihypertensive treatment or including it as a covariate in a regression model underestimated the effects of diabetes and obesity on underlying blood pressure, compared to the recommended method of the censored normal regression. CONCLUSION: Proper accounting for antihypertensive treatment is needed in interpreting variables that affect blood pressure. Published by Elsevier Inc.
Authors: Brinda K Rana; Anish Dhamija; Matthew S Panizzon; Kelly M Spoon; Terrie Vasilopoulos; Carol E Franz; Michael D Grant; Kristen C Jacobson; Kathleen Kim; Michael J Lyons; Jeanne M McCaffery; Phyllis K Stein; Hong Xian; Daniel T O'Connor; William S Kremen Journal: Am J Hypertens Date: 2014-02-14 Impact factor: 2.689
Authors: Mark L Unruh; Soraya Arzhan; Harold I Feldman; Helen C Looker; Robert G Nelson; Thomas Faber; David Johnson; Linda Son-Stone; Vernon S Pankratz; Larissa Myaskovsky; Vallabh O Shah Journal: BMC Nephrol Date: 2020-07-22 Impact factor: 2.388