Is drug treatment of hypertension in clinical practice as effective as in randomized controlled trials with regard to the reduction of the incidence of stroke?

Epidemiology
O H KlungelA de Boer

Abstract

The results from several nonexperimental studies suggest that drug treatment of hypertension in daily clinical practice may not be as effective as in randomized controlled trials. These nonexperimental studies had limitations with regard to the selection of an appropriate control group. The objective of our study was to assess the effect of drug treatment of hypertension under circumstances of everyday medical practice on the incidence of stroke by using a prognostically comparable untreated reference group. Within two prospective, population-based cohort studies among 45,000 men and women 20 years of age and older in the Netherlands, we selected a cohort of 2,301 hypertensive subjects who either received drug treatment for hypertension (N = 1,318) or were untreated for hypertension but were determined to be "candidates" for drug treatment on the basis of their level of blood pressure and the presence of other cardiovascular risk factors (N = 983). Follow-up averaged 4.6 years and was complete for 91% of the hypertensives. Compared with untreated hypertensive subjects who were "candidates" for drug treatment, subjects who received drug treatment for hypertension had, after adjustment for potential confounders, a 39% [95% confid...Continue Reading

References

Jul 1, 1991·European Journal of Epidemiology·A HofmanF A van den Ouweland
Jun 30, 1988·The New England Journal of Medicine·A LaupacisR S Roberts
Apr 1, 1986·Journal of Hypertension·C G IslesJ W Robertson
Apr 4, 1981·British Medical Journal·J A TraffordR Evans
Dec 30, 1993·The New England Journal of Medicine·W A RayJ Avorn
May 11, 1996·BMJ : British Medical Journal·N Black
Feb 1, 1996·American Journal of Hypertension·B M PsatyC D Furberg
Dec 31, 1997·BMJ : British Medical Journal·D E Grobbee, A W Hoes
Jul 9, 1998·American Journal of Hypertension·L E RamsayP R Jackson
Jul 17, 1998·BMJ : British Medical Journal·O K AnderssonL Wilhelmsen
Jun 12, 1999·Journal of the American Geriatrics Society·B M PsatyC D Furberg
Jul 2, 1999·Stroke; a Journal of Cerebral Circulation·O H Klungel Anthonius de Boer
Jul 27, 1999·Archives of Internal Medicine·F H MesserliZ Feng

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Citations

Jul 8, 2005·Pharmacy World & Science : PWS·Paul HommersonDaan Kromhout
Mar 26, 2005·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Monica A FisherBrent J Shelton
Dec 25, 2004·Journal of Clinical Epidemiology·Olaf H KlungelA de Boer
Oct 16, 2004·Journal of Clinical Epidemiology·Monica A FisherBrent J Shelton
Dec 31, 2008·Hypertension·Norm R C CampbellUNKNOWN Canadian Hypertension Education Program Outcomes Research Task Force
Feb 9, 2005·Pharmacoepidemiology and Drug Safety·Leif Jonsson, Cecilia Stålsby Lundborg

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