Temporal Patterns of Antihypertensive Medication Use Among Older Adults, 1989 Through 1992

摘要: Objective. —To describe the changing patterns of antihypertensive medication use in years immediately before and after publication results three major clinical trials treatment hypertension older adults. Design. —In this cohort study, adults 65 or were examined annually on four occasions between June 1989 May 1992, medications was assessed by inventory at each visit. The visits defined boundaries study periods. For period, participants receiving therapy either continuous users (n = 1667, 1643, 1605, respectively) starters 157,142,120) hypertensive therapy. large that convincingly proved efficacy safety low-dose diuretic published during latter parts period 2 early 3. Results. —Among starters, proportion initiating diuretics increased from 35.9% to 47.5% 3, significantly so among women ( P =.04). proportions other drugs displayed no significant trends. Among users, diuretics, β-blockers, vasodilators generally decreased over 3-year while calcium channel blockers angiotensin-converting enzyme inhibitors periods =.03) almost a complete halt 3 (0.2% decline). rate increase slowed =.01) 1 (+6.7%) (+2.8%). Conclusions. —Although factors such as cost may have been important, temporal trends drug coincided time with reflected part influence practice. JAMA . 1995;273:1436-1438)