ArticleJournal of clinical hypertension (Greenwich, Conn.)2019
First-line treatment of essential hypertension: A real-world analysis across four antihypertensive treatment classes.
Article in Journal of clinical hypertension (Greenwich, Conn.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Choosing real-world data for clinical and epidemiological research: methodological lessons from NHIRD and TriNetX-A narrative review.Annals of medicine · 2026Review
- Pre-existing anxiety and mood disorders and multisystem outcomes in young adults with chronic kidney disease.Clinical kidney journal · 2026Article
- Risk of Antipsychotic Initiation Among Older Dementia Patients Initiating Cholinesterase Inhibitors.Drug, healthcare and patient safety · 2025Article
- Health outcomes in chronic kidney disease patients with cognitive impairment or dementia: a global collaborative analysis.Clinical kidney journal · 2025Article
- Efficacy and neural mechanism of acupuncture for essential hypertension: Study protocol for a randomized clinical trial.PloS one · 2025Article
- Assessing treatment switch among patients with multiple sclerosis: A machine learning approach.Exploratory research in clinical and social pharmacy · 2023Article
- Non-persistence to antihypertensive drug therapy in Lithuania.European journal of clinical pharmacology · 2022Article
- Cryo-EM reveals mechanisms of angiotensin I-converting enzyme allostery and dimerization.The EMBO journal · 2022Article
- Management of Diabetes and Hypertension within the Gulf Region: Updates on Treatment Practices and Therapies.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2022Review
- Big Data in Cardiology: State-of-Art and Future Prospects.Frontiers in cardiovascular medicine · 2022Review
- Effect of Acupuncture on Blood Pressure and Metabolic Profile Among Patients With Essential Hypertension: Protocol of a Randomized Clinical Trial.Frontiers in cardiovascular medicine · 2022Article
- A statistical quality assessment method for longitudinal observations in electronic health record data with an application to the VA million veteran program.BMC medical informatics and decision making · 2021Article
- Abuse-deterrent extended-release oxycodone and risk of opioid-related harm.Addiction (Abingdon, England) · 2021Article
- Antimuscarinic Cascade Across Individual Cholinesterase Inhibitors in Older Adults with Dementia.Drugs & aging · 2021Article
- Network Pharmacology and Molecular Docking Combined to Analyze the Molecular and Pharmacological Mechanism ofCurrent issues in molecular biology · 2021Article
- Dissociation between reduced pain and arterial blood pressure following epidural spinal cord stimulation in patients with chronic pain: A retrospective study.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Article
- Immunosuppression in chronic autoimmune neurological disorders during the COVID-19 pandemic.Journal of the neurological sciences · 2021Article
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2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The relative efficacy of antihypertensive treatment has been assessed primarily by randomized clinical trials (RCTs). The increasing availability of electronic medical records (EMR) allows results from RCT to be compared to data from actual clinical practice. EMR from TriNetX were used to compare patients starting and adhering to antihypertensive treatment on diuretics, beta blockers, angiotensin II or ACE inhibitors, or calcium channel blockers for at least 36 months. Cardiovascular (CV) events as defined by ICD-10 codes were evaluated for an observation period of three years. Outcomes were assessed with and without propensity score matching for confounding factors. A total of 79 288 patients fulfilled the criteria for first-line therapy and adherence (17.4% diuretics, 25.9% beta blockers, 45.1% inhibitors of the renin-angiotensin system, and 11.6% calcium channel blockers). Differences in demography and comorbidities were consistent with expectations based on treatment guidelines. RAS blockers showed the best BP control (28.7% episodes of uncontrolled BP) and, together with diuretics, the lowest rate of CV events (diuretics, 5.2%; RAS blockers, 5.4%). Beta blockers were associated with the highest rate of uncontrolled BP (45.9%) and a high CV event rate (9.5%). These trends remained after matching the cohorts for confounding factors. EMR show that actual prescribing behavior for first-line treatment of essential hypertension reflects treatment guidelines. Patients taking either RAS blockers or diuretics experienced the lowest CV event rates. Beta blockers, even when adjusted for pre-existing cardiovascular conditions, do not seem to be as protective against CV events as the three other classes.
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