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Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials.

Publication ,  Journal Article
Frazier, CG; Shah, SH; Armstrong, PW; Bhapkar, MV; McGuire, DK; Sadowski, Z; Kristinsson, A; Aylward, PE; Klein, WW; Weaver, WD; Newby, LK ...
Published in: Am Heart J
December 2005

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.

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

December 2005

Volume

150

Issue

6

Start / End Page

1260 / 1267

Location

United States

Related Subject Headings

  • Sex Characteristics
  • Platelet Aggregation Inhibitors
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Coronary Disease
  • Chemistry, Pharmaceutical
 

Citation

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Chicago
ICMJE
MLA
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Frazier, C. G., Shah, S. H., Armstrong, P. W., Bhapkar, M. V., McGuire, D. K., Sadowski, Z., … SYMPHONY and the Second SYMPHONY Investigators, . (2005). Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials. Am Heart J, 150(6), 1260–1267. https://doi.org/10.1016/j.ahj.2005.08.004
Frazier, Camille G., Svati H. Shah, Paul W. Armstrong, Manjushri V. Bhapkar, Darren K. McGuire, Zygmunt Sadowski, Arni Kristinsson, et al. “Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials.Am Heart J 150, no. 6 (December 2005): 1260–67. https://doi.org/10.1016/j.ahj.2005.08.004.
Frazier CG, Shah SH, Armstrong PW, Bhapkar MV, McGuire DK, Sadowski Z, Kristinsson A, Aylward PE, Klein WW, Weaver WD, Newby LK, SYMPHONY and the Second SYMPHONY Investigators. Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials. Am Heart J. 2005 Dec;150(6):1260–1267.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

December 2005

Volume

150

Issue

6

Start / End Page

1260 / 1267

Location

United States

Related Subject Headings

  • Sex Characteristics
  • Platelet Aggregation Inhibitors
  • Myocardial Ischemia
  • Middle Aged
  • Male
  • Hypertension
  • Humans
  • Female
  • Coronary Disease
  • Chemistry, Pharmaceutical