PMID- 34115112
OWN - NLM
STAT- MEDLINE
DCOM- 20211129
LR  - 20220716
IS  - 1941-7225 (Electronic)
IS  - 0895-7061 (Print)
IS  - 0895-7061 (Linking)
VI  - 34
IP  - 10
DP  - 2021 Oct 27
TI  - Correlations Among Visit-to-Visit Blood Pressure Variability and Treatment With 
      Antihypertensive Medication With Long-Term Adverse Outcomes in a Large Veteran 
      Cohort.
PG  - 1092-1099
LID - 10.1093/ajh/hpab087 [doi]
AB  - BACKGROUND: Blood pressure variability (BPV) is associated with adverse events 
      (AEs) independently of hypertension. It has been suggested that calcium channel 
      blockers (CCBs) may reduce BPV, and thus be particularly valuable in 
      hypertensives with high BPV. We sought to investigate how CCB affect BPV 
      progression and whether long-term adverse effects of BPV differ after CCB 
      treatment than after treatment with other antihypertensives. METHODS: We 
      retrospectively analyzed 25,268 US veterans who had been followed for 3 years 
      without hypertensive therapy, started on a single class of antihypertensive 
      agents (thiazides, CCBs, ACE inhibitors, or beta blockers [BBs]), treated for 6 
      years, and then followed for 3 additional years. BPV was calculated as SD of 
      systolic or diastolic blood pressures from at least 10 measurements over each 
      3-year period. A combined AE endpoint included hospitalization, coronary artery 
      bypass grafting, carotid endarterectomy, angioplasty, amputation, arteriovenous 
      fistula creation, and mortality was assessed in years 9-12. RESULTS: 
      Post-medication high BPV and BB or thiazide use were associated with increased AE 
      risk. Medication type also affected mean post-medication BPV. The effects of 
      medications except for BBs on AE and mortality was independent of the patient 
      BPV. CONCLUSIONS: The possible deleterious effects of thiazides should be 
      considered within the context of the study population, who were mostly male and 
      received only a single class of hypertensives. While CCB may ameliorate BPV over 
      time, this study does not support choosing CCB over other agents specifically to 
      lessen BPV-associated risk.
CI  - (c) American Journal of Hypertension, Ltd 2021. All rights reserved. For 
      Permissions, please email: journals.permissions@oup.com.
FAU - Basson, Marc D
AU  - Basson MD
AUID- ORCID: 0000-0001-9696-2789
AD  - Department of Surgery, University of North Dakota School of Medicine and Health 
      Sciences, Grand Forks, North Dakota, USA.
AD  - Department of Research Service, Fargo VA Medical Center, Fargo, North Dakota, 
      USA.
FAU - Newman, William E
AU  - Newman WE
AD  - Department of Internal Medicine, University of North Dakota School of Medicine 
      and Health Sciences, Grand Forks, North Dakota, USA.
AD  - Department of Internal Medicine Service, Fargo VA Medical Center, Fargo, North 
      Dakota, USA.
FAU - Klug, Marilyn G
AU  - Klug MG
AD  - Department of Population Health, University of North Dakota School of Medicine 
      and Health Sciences, Grand Forks, North Dakota, USA.
LA  - eng
GR  - U54 GM128729/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Am J Hypertens
JT  - American journal of hypertension
JID - 8803676
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Calcium Channel Blockers)
RN  - 0 (Thiazides)
SB  - IM
MH  - Adrenergic beta-Antagonists/adverse effects
MH  - *Antihypertensive Agents/adverse effects
MH  - *Blood Pressure/physiology
MH  - Calcium Channel Blockers/adverse effects
MH  - Female
MH  - Humans
MH  - *Hypertension/drug therapy/epidemiology
MH  - Male
MH  - Retrospective Studies
MH  - Thiazides/adverse effects
MH  - Treatment Outcome
MH  - Veterans
PMC - PMC8557467
OTO - NOTNLM
OT  - ACE inhibitors
OT  - beta blockers
OT  - blood pressure
OT  - blood pressure variability
OT  - calcium channel blockers
OT  - hypertension
OT  - thiazide diuretics
EDAT- 2021/06/12 06:00
MHDA- 2021/11/30 06:00
PMCR- 2022/06/11
CRDT- 2021/06/11 12:19
PHST- 2021/03/17 00:00 [received]
PHST- 2021/05/13 00:00 [revised]
PHST- 2021/06/07 00:00 [accepted]
PHST- 2021/06/12 06:00 [pubmed]
PHST- 2021/11/30 06:00 [medline]
PHST- 2021/06/11 12:19 [entrez]
PHST- 2022/06/11 00:00 [pmc-release]
AID - 6296809 [pii]
AID - hpab087 [pii]
AID - 10.1093/ajh/hpab087 [doi]
PST - ppublish
SO  - Am J Hypertens. 2021 Oct 27;34(10):1092-1099. doi: 10.1093/ajh/hpab087.