ReviewArchives of internal medicine1995
Trends in pharmacologic management of hypertension in the United States.
Review in Archives of internal medicine, 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00000542. Cited by 30 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)
Who cites it
30 citing papers in PubMed, 177 citations in OpenAlex.
- Efficacy and safety of standard dose triple combination of telmisartan 80 mg/amlodipine 5 mg/chlorthalidone 25 mg in primary hypertension: A randomized, double-blind, active-controlled, multicenter phase 3 trial.Journal of clinical hypertension (Greenwich, Conn.) · 2023Trial
- The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes.Diabetes care · 1999Trial
- A computerized intervention to decrease the use of calcium channel blockers in hypertension.Journal of general internal medicine · 1997Trial
- To what extent do prescribing practices for hypertension in the private sector in Zimbabwe follow the national treatment guidelines? An analysis of insurance medical claims.Journal of pharmaceutical policy and practice · 2017Article
- Ion channel remodeling in vascular smooth muscle during hypertension: Implications for novel therapeutic approaches.Pharmacological research · 2013Review
- The impact of differences in methodology and population characteristics on the prevalence of hypertension in US adults in 1976-1980 and 1999-2002.American journal of hypertension · 2010Article
- Management of high blood pressure in clinical practice: perceptible qualitative differences in approaches utilized by clinicians.Journal of clinical hypertension (Greenwich, Conn.) · 2008Article
- Antihypertensive medication prescription patterns and time trends for newly-diagnosed uncomplicated hypertension patients in Taiwan.BMC health services research · 2008Article
- Thiazide-type diuretics and beta-adrenergic blockers as first-line drug treatments for hypertension.Circulation · 2008Review
- Prescribing pattern of antihypertensive drugs in primary care units in Turkey: results from the TURKSAHA study.European journal of clinical pharmacology · 2007Article
- Explicit and implicit evaluation of physician adherence to hypertension guidelines.Journal of clinical hypertension (Greenwich, Conn.) · 2007Article
- Prescribing patterns of diuretics in multi-drug antihypertensive regimens.Journal of clinical hypertension (Greenwich, Conn.) · 2005Article
- Measuring adherence to practice guidelines for the management of hypertension: an evaluation of the literature.Hypertension (Dallas, Tex. : 1979) · 2004Review
- Misperceptions about beta-blockers and diuretics: a national survey of primary care physicians.Journal of general internal medicine · 2003Article
- Cost-effectiveness of hypertension treatment: a population-based study.Sao Paulo medical journal = Revista paulista de medicina · 2002Article
- Influence of physician specialty on adoption and relinquishment of calcium channel blockers and other treatments for myocardial infarction.Journal of general internal medicine · 2001Article
- Economics of antihypertensive therapy in the elderly.Drugs & aging · 2001Review
- Failure of evidence-based medicine in the treatment of hypertension in older patients.Journal of general internal medicine · 2000Article
- The influence of national guidelines on antihypertensive prescribing patterns.Current hypertension reports · 2000Article
- Trends in the prevalence and treatment of hypertension in Halifax County from 1985 to 1995.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1999Article
Corrections and comments
- Commented on by
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTwo new classes of antihypertensive agents were introduced in the 1980s, but their effectiveness in preventing heart disease and stroke has not been demonstrated. Lack of evidence of their efficacy might reasonably be expected to discourage their widespread use in management of hypertension.
methodsUse of various classes of antihypertensive agents was estimated from published drug use information in an effort to estimate trends in antihypertensive drug use and evaluate the impact of these trends on costs of antihypertensive therapy in the United States.
resultsProportionate use of the five major antihypertensive drug classes shifted markedly between 1982 and 1993. Diuretics accounted for 56% of all hypertensive drug mentions in 1982 but only 27% in 1993, a relative decline of 52%. Use of beta-blockers and central agents also declined during this period. Proportionate use of calcium antagonists showed the greatest gains, increasing from 0.3% to 27%, while the use of angiotensin-converting enzyme inhibitors increased from 0.8% to 24%. Given the higher costs of the newer agents, and assuming an estimated total cost of antihypertensive medications in 1992 of $7 billion, approximately $3.1 billion would have been saved had 1982 prescribing practices remained in effect in 1992.
conclusionsUse of calcium antagonists and angiotensin-converting enzyme inhibitors in hypertension has increased dramatically in the past 10 years. Without convincing evidence of the advantages of these agents, it is difficult to explain the continued decline in the use of less expensive agents, such as diuretics and beta-blockers, which are the only antihypertensive agents proved to reduce stroke and coronary disease in hypertensive patients.
Indexed as
Identifiers
7717791W1985388908What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.