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Mortality and Macrovascular Risk in Elderly With Hypertension and Diabetes: Effect of Intensive Drug Therapy.

Publication ,  Journal Article
Yashkin, AP; Kravchenko, J; Yashin, AI; Sloan, F
Published in: Am J Hypertens
January 12, 2018

BACKGROUND: This study identifies the effect of intensive drug therapy (IDT) in individuals age 65+ with diabetes (type 2 diabetes mellitus (T2D)) and hypertension on all-cause death, congestive heart failure (CHF), hospitalization for myocardial infarction (MI), and stroke or transient ischemic attack (TIA). METHODS: Individuals from the Medicare 5% dataset with hypertension and T2D undergoing IDT for these conditions were propensity score matched to a nonintensive drug-therapy group. Hazard ratios (HRs) were obtained using the Cox proportional hazard model. RESULTS: IDT was associated with increased risk of CHF (HR 2.32; 95% confidence interval (CI) 2.32-2.38), MI (HR 4.27; 95% CI 4.05-4.52), and stroke or TIA (HR 1.80; 95% CI 1.70-1.89) but decreased risk of death (HR 0.95; 95% CI 0.93-0.97). Risk for CHF (HR 0.73; 95% CI 0.71-0.73), MI (HR 0.64; 95% CI 0.62-0.67), stroke or TIA (HR 0.82; 95% CI 0.78-0.86), and death (HR 0.29; 95% CI 0.28-0.29) was decreased by adherence to diabetes management guidelines. CONCLUSIONS: Use of IDT in a high-risk population delays death but not severe macrovascular outcomes. Protective effects of IDT in high-risk patients likely outweigh polypharmacy-related health concerns.

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Published In

Am J Hypertens

DOI

EISSN

1941-7225

Publication Date

January 12, 2018

Volume

31

Issue

2

Start / End Page

220 / 227

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Myocardial Infarction
  • Mortality
  • Medication Adherence
  • Medicare
  • Male
  • Hypoglycemic Agents
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Yashkin, A. P., Kravchenko, J., Yashin, A. I., & Sloan, F. (2018). Mortality and Macrovascular Risk in Elderly With Hypertension and Diabetes: Effect of Intensive Drug Therapy. Am J Hypertens, 31(2), 220–227. https://doi.org/10.1093/ajh/hpx151
Yashkin, Arseniy P., Julia Kravchenko, Anatoliy I. Yashin, and Frank Sloan. “Mortality and Macrovascular Risk in Elderly With Hypertension and Diabetes: Effect of Intensive Drug Therapy.Am J Hypertens 31, no. 2 (January 12, 2018): 220–27. https://doi.org/10.1093/ajh/hpx151.
Yashkin AP, Kravchenko J, Yashin AI, Sloan F. Mortality and Macrovascular Risk in Elderly With Hypertension and Diabetes: Effect of Intensive Drug Therapy. Am J Hypertens. 2018 Jan 12;31(2):220–7.
Yashkin, Arseniy P., et al. “Mortality and Macrovascular Risk in Elderly With Hypertension and Diabetes: Effect of Intensive Drug Therapy.Am J Hypertens, vol. 31, no. 2, Jan. 2018, pp. 220–27. Pubmed, doi:10.1093/ajh/hpx151.
Yashkin AP, Kravchenko J, Yashin AI, Sloan F. Mortality and Macrovascular Risk in Elderly With Hypertension and Diabetes: Effect of Intensive Drug Therapy. Am J Hypertens. 2018 Jan 12;31(2):220–227.
Journal cover image

Published In

Am J Hypertens

DOI

EISSN

1941-7225

Publication Date

January 12, 2018

Volume

31

Issue

2

Start / End Page

220 / 227

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Myocardial Infarction
  • Mortality
  • Medication Adherence
  • Medicare
  • Male
  • Hypoglycemic Agents