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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied the therapeutic substitution of a less expensive but equally effective antihypertensive agent and assessed patient outcome. The medication of 39 patients with hypertension was changed from once-daily diltiazem hydrochloride (Cardizem CD) or nifedipine (Procardia XL) to felodipine (Plendil). Titration to a final dose was based on home and office blood pressure measurements assessed over subsequent follow-up clinic visits. Self-administered questionnaires measured different aspects of well-being and symptoms before and after the change in medication. Eighty percent of the cohort switched successfully to felodipine. Office systolic and diastolic pressures improved after the medication change (systolic: 150 mm Hg versus 144 mm Hg; diastolic: 92 mm Hg versus 87 mm Hg). No statistically significant differences were found among the 39 symptoms measured. A yearly savings potential for our institution was estimated to be $72,000.
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PMID:Felodipine as an alternative to more expensive calcium antagonists in mild to moderate hypertension. 863 95

Achieving an adequate sample size is one of the major difficulties in performing post-marketing observational studies of health outcomes in persons taking specific drug preparations. We assessed the feasibility of recruiting participants for such a study of Cardizem CD from approximately 400,000 U.S. recipients of a health promotion newsletter. A three-page questionnaire was sent to a 2.5% random sample (n = 10,000) of recipients, stratified by geographic region. After two mailings, 2779 (28%) returned the questionnaire. Of the 2779 respondents, 2132 (77%) reported having high blood pressure. Eighty-seven percent indicated a willingness to participate in a long-term prospective study. In a multivariate model, calcium channel blocker (CCB) use was associated with a history of coronary heart disease, duration of hypertension medication use greater than 1 year, a rating of good or excellent hypertension care, higher systolic blood pressure, higher education level, family history of cardiovascular disease, and history of smoking. These results indicate that self-reported CCB users may be at greater risk of cardiovascular heart disease and that it is feasible to use health promotion newsletters as a source of participants in prospective studies of cardiovascular disease.
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PMID:Feasibility of using recipients of health promotional newsletters for post-marketing surveillance. 1088 Jul 86

This study was undertaken to assess the safety and efficacy of a new long-acting formulation of diltiazem (DLA) (Cardizem LA; Biovail Pharmaceuticals, Inc., Bridgewater, NJ) in a large heterogeneous group of hypertensive patients, and to evaluate physician and patient treatment satisfaction. In this open-label, 30-day study, physicians enrolled patients with hypertension who were to be evaluated and treated at an initial visit and at 2 follow-up visits. Data recorded for each patient included demographic information, DLA dosing strength, blood pressure (BP) readings, and adverse events (AEs). A total of 15,155 physicians completed the baseline questionnaire, and 9679 (64%) completed the final clinical evaluation questionnaire. In all, 139,965 patients with hypertension were enrolled. Initial and follow-up BP data were recorded for 50,856 (36%) of these patients. On average, systolic BP (SBP) decreased from the initial visit by 10.9 mm Hg at the first follow-up (P<.0001) and by 15.5 mm Hg at the second follow-up (mean SBP, 135.7) (P<.0001). On average, diastolic BP (DBP) decreased by 6.7 mm Hg (P<.0001) and by 9.2 mm Hg (mean DBP, 79.4) (P<.0001), respectively. The most commonly reported AEs included edema, headache, dizziness, nausea, and rash; two thirds of these events were attributed to DLA. None of the AEs attributed to DLA was reported in more than 1% of patients. Both physicians and patients expressed a high degree of satisfaction with DLA. Results from this large-scale, open-label study show that DLA was safe and produced clinically meaningful reductions in SBP and DBP; in addition, a moderate to high degree of physician and patient satisfaction was reported in a large and heterogeneous cohort of patients with hypertension.
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PMID:Antihypertensive safety and efficacy and physician and patient satisfaction: results from a phase 4 practice-based clinical experience trial with diltiazem LA. 1675 Nov 61