Health Outcomes Associated With Antihypertensive Therapies Used as First-Line Agents&lt;subtitle&gt;A Systematic Review and Meta-analysis&lt;/subtitle&gt;

Psaty, Bruce M.; Smith, Nicholas L.; Siscovick, David S.; Koepsell, Thomas D.; Weiss, Noel S.; Heckbert, Susan R.; Lemaître, Rozenn N.; Wagner, Edward H.; Furberg, Curt D.

doi:10.1001/jama.1997.03540330061036

Cited by 708 publications

(54 citation statements)

References 65 publications

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“…Each of the 4 drug groups had been previously tested in a controlled trial and demonstrated to reduce morbidity and mortality [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]. However, because these trials were performed in a controlled environment, it is necessary to examine how their results translate into clinical reality in large, prospective, and unselected patient cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…However, attempts to predict future events by the present cardiac condition may become increasingly challenging as powerful therapeutic interventions emerge that are bound to alter the natural course of cardiovascular disease. Four drug classes - platelet inhibitors, β-blockers, statins, and angiotensin-converting enzyme inhibitors (ACEI) - have been shown to reduce cardiovascular morbidity and mortality in large randomized controlled trials [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]. These studies have demonstrated a risk reduction between 20 and 30% for each drug in acute myocardial infarction, in stable coronary artery disease, and in high-risk individuals without clinical evidence of atherosclerosis [8,10,12,19,20,22,23].…”

Section: Introductionmentioning

confidence: 99%

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Estimating Mortality in Survivors of the Acute Coronary Syndrome by the 4-Drug Score

Kopel¹,

Klempfner²,

Goldenberg³

et al. 2013

Cardiology

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Objective: Four drug classes, platelet inhibitors, β-blockers, statins, and angiotensin-converting enzyme inhibitors (or angiotensin receptor blockers), have been shown to reduce mortality in clinical trials. We sought to evaluate whether the simple number of secondary prevention drugs at discharge is independently associated with 1-year mortality in acute coronary syndrome (ACS) patients. Methods: We analyzed a prospective cohort study using data of all 5 Acute Coronary Syndrome Israeli Surveys (ACSIS) conducted between 2002 and 2010 in all Israeli cardiology departments. All 9,107 hospital survivors of ACS participated. Results: A score from 1 to 4 discharge drugs was significantly associated with gradual decreasing rates of 1-year mortality (14.4, 9.0, 5.1, and 3.6%, respectively; p for trend <0.001). Only when the number of discharge drugs increased to 3-4 as a result of the intervention during hospitalization in patients initially admitted with 0-2 drugs, a significant multivariate-adjusted decrease in the hazard ratio (HR), independent of multiple baseline, admission presentation, and in-hospital course characteristics, was measured (HR, 0.66; 95% confidence interval, 0.50-0.87). Conclusion: The use of a higher number of secondary prevention drugs at discharge following ACS was associated with significantly lower mortality rates, particularly in patients with mono- or dual-baseline therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estimating Mortality in Survivors of the Acute Coronary Syndrome by the 4-Drug Score

Kopel¹,

Klempfner²,

Goldenberg³

et al. 2013

Cardiology

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show abstract

“…High blood pressure (BP) is a major risk factor for strokes and heart disease ( 1 ) that is treatable with lifestyle changes and medication ( 2 ). However, hypertension awareness and control rates are low ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Smartphone-based blood pressure monitoring via the oscillometric finger-pressing method

et al. 2018

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High blood pressure (BP) is a major cardiovascular risk factor that is treatable, yet hypertension awareness and control rates are low. Ubiquitous BP monitoring technology could improve hypertension management, but existing devices require an inflatable cuff and are not compatible with such anytime, anywhere measurement of BP. We extended the oscillometric principle, which is used by most automatic cuff devices, to develop a cuff-less BP monitoring device using a smartphone. As the user presses her/his finger against the smartphone, the external pressure of the underlying artery is steadily increased while the phone measures the applied pressure and resulting variable-amplitude blood volume oscillations. A smartphone application provides visual feedback to guide the amount of pressure applied over time via the finger pressing and computes systolic and diastolic BP from the measurements. We prospectively tested the smartphone-based device for real-time BP monitoring in human subjects to evaluate usability (n = 30) and accuracy against a standard automatic cuff-based device (n = 32). We likewise tested a finger cuff device, which uses the volume-clamp method of BP detection. About 90% of the users learned the finger actuation required by the smartphone-based device after one or two practice trials. The device yielded bias and precision errors of 3.3 and 8.8 mmHg for systolic BP and −5.6 and 7.7 mmHg for diastolic BP over a 40 to 50 mmHg range of BP. These errors were comparable to the finger cuff device. Cuff-less and calibration-free monitoring of systolic and diastolic BP may be feasible via a smartphone.

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“…High blood pressure (BP) is a major, modifiable cardiovascular risk factor 1,2 , yet hypertension awareness and control rates are low 3 . Ubiquitous BP monitoring could improve these rates, but existing devices require inflatable cuffs and thus do not afford such monitoring.…”

Section: Introductionmentioning

confidence: 99%

An iPhone Application for Blood Pressure Monitoring via the Oscillometric Finger Pressing Method

Chandrasekhar

Natarajan

Yavarimanesh

et al. 2018

Sci Rep

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We developed an iPhone X application to measure blood pressure (BP) via the “oscillometric finger pressing method”. The user presses her fingertip on both the front camera and screen to increase the external pressure of the underlying artery, while the application measures the resulting variable-amplitude blood volume oscillations via the camera and applied pressure via the strain gauge array under the screen. The application also visually guides the fingertip placement and actuation and then computes BP from the measurements just like many automatic cuff devices. We tested the application, along with a finger cuff device, against a standard cuff device. The application yielded bias and precision errors of −4.0 and 11.4 mmHg for systolic BP and −9.4 and 9.7 mmHg for diastolic BP (n = 18). These errors were near the finger cuff device errors. This proof-of-concept study surprisingly indicates that cuff-less and calibration-free BP monitoring may be feasible with many existing and forthcoming smartphones.

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Health Outcomes Associated With Antihypertensive Therapies Used as First-Line Agents<subtitle>A Systematic Review and Meta-analysis</subtitle>

Cited by 708 publications

References 65 publications

Estimating Mortality in Survivors of the Acute Coronary Syndrome by the 4-Drug Score

Estimating Mortality in Survivors of the Acute Coronary Syndrome by the 4-Drug Score

Smartphone-based blood pressure monitoring via the oscillometric finger-pressing method

An iPhone Application for Blood Pressure Monitoring via the Oscillometric Finger Pressing Method

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