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Comparison of First-Line Dual Combination Treatments in Hypertension: Real-World Evidence from Multinational Heterogeneous Cohorts

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dc.contributor.author박성하-
dc.date.accessioned2020-02-26T06:48:27Z-
dc.date.available2020-02-26T06:48:27Z-
dc.date.issued2020-
dc.identifier.issn1738-5520-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/175295-
dc.description.abstractBACKGROUND AND OBJECTIVES: 2018 ESC/ESH Hypertension guideline recommends 2-drug combination as initial anti-hypertensive therapy. However, real-world evidence for effectiveness of recommended regimens remains limited. We aimed to compare the effectiveness of first-line anti-hypertensive treatment combining 2 out of the following classes: angiotensin-converting enzyme (ACE) inhibitors/angiotensin-receptor blocker (A), calcium channel blocker (C), and thiazide-type diuretics (D). METHODS: Treatment-naïve hypertensive adults without cardiovascular disease (CVD) who initiated dual anti-hypertensive medications were identified in 5 databases from US and Korea. The patients were matched for each comparison set by large-scale propensity score matching. Primary endpoint was all-cause mortality. Myocardial infarction, heart failure, stroke, and major adverse cardiac and cerebrovascular events as a composite outcome comprised the secondary measure. RESULTS: A total of 987,983 patients met the eligibility criteria. After matching, 222,686, 32,344, and 38,513 patients were allocated to A+C vs. A+D, C+D vs. A+C, and C+D vs. A+D comparison, respectively. There was no significant difference in the mortality during total of 1,806,077 person-years: A+C vs. A+D (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.97-1.20; p=0.127), C+D vs. A+C (HR, 0.93; 95% CI, 0.87-1.01; p=0.067), and C+D vs. A+D (HR, 1.18; 95% CI, 0.95-1.47; p=0.104). A+C was associated with a slightly higher risk of heart failure (HR, 1.09; 95% CI, 1.01-1.18; p=0.040) and stroke (HR, 1.08; 95% CI, 1.01-1.17; p=0.040) than A+D. CONCLUSIONS: There was no significant difference in mortality among A+C, A+D, and C+D combination treatment in patients without previous CVD. This finding was consistent across multi-national heterogeneous cohorts in real-world practice.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish, Korean-
dc.publisherKorean Society of Circulation-
dc.relation.isPartOfKOREAN CIRCULATION JOURNAL-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleComparison of First-Line Dual Combination Treatments in Hypertension: Real-World Evidence from Multinational Heterogeneous Cohorts-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorSeng Chan You-
dc.contributor.googleauthorSungjae Jung-
dc.contributor.googleauthorJoel N. Swerdel-
dc.contributor.googleauthorPatrick B. Ryan-
dc.contributor.googleauthorMartijn J. Schuemie-
dc.contributor.googleauthorMarc A. Suchard-
dc.contributor.googleauthorSeongwon Lee-
dc.contributor.googleauthorJaehyeong Cho-
dc.contributor.googleauthorGeorge Hripcsak-
dc.contributor.googleauthorRae Woong Park-
dc.contributor.googleauthorSungha Park-
dc.identifier.doi10.4070/kcj.2019.0173-
dc.contributor.localIdA01512-
dc.relation.journalcodeJ01952-
dc.identifier.eissn1738-5555-
dc.identifier.pmid31642211-
dc.subject.keywordAngiotensin receptor antagonists-
dc.subject.keywordAntihypertensive agents-
dc.subject.keywordCalcium channel blockers-
dc.subject.keywordDiuretics-
dc.subject.keywordHypertension-
dc.contributor.alternativeNamePark, Sung Ha-
dc.contributor.affiliatedAuthor박성하-
dc.citation.volume50-
dc.citation.number1-
dc.citation.startPage52-
dc.citation.endPage68-
dc.identifier.bibliographicCitationKOREAN CIRCULATION JOURNAL, Vol.50(1) : 52-68, 2020-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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