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Utility of a Systolic Blood Pressure Polygenic Risk Score With Chlorthalidone Response.
JAMA Cardiol
December 2024
Department of Epidemiology, University of Alabama at Birmingham.
Article Synopsis
- A study investigated how well a polygenic risk score (PRS) for systolic blood pressure (SBP) can predict patients' responses to antihypertensive treatment and the risk of treatment-resistant hypertension.
- The research focused on participants from the GenHAT study, specifically Black individuals who were assigned to treatment groups involving chlorthalidone or lisinopril.
- The main outcomes measured were changes in blood pressure after six months and the likelihood of being classified as treatment-resistant hypertension based on defined criteria.
Prevention of Heart Failure in Hypertension-the Role of Coronary Heart Disease Events Treated With Versus Without Revascularization: The ALLHAT Study.
Am J Cardiol
November 2024
Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio; Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:
In modern clinical practice, less than half of patients with new-onset heart failure (HF) undergo ischemic evaluation and only a minority undergo revascularization. We aimed to assess the proportion of the effect of hypertension (antihypertensive treatment) on incident HF to be eliminated by prevention of coronary heart disease (CHD) event treated with or without revascularization, considering possible treatment-mediator interaction. The causal mediation analysis of Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) included 42,418 participants (age 66.
View Article and Find Full Text PDFCardiovascular diseases (CVDs) continue to be a worldwide health concern, requiring effective strategies for risk reduction. This article explores the extensive collaboration between medical therapy and lifestyle modifications in the management of CVDs, aiming to interpret whether a single approach holds the key to reducing major cardiovascular events. In the realm of pharmaceutical therapy, statins, beta-blockers, angiotensin-converting-enzyme (ACE) inhibitors, and antiplatelet agents have shown significant effectiveness, as evidenced by landmark trials such as Scandinavian Simvastatin Survival Study (4S) and Heart Outcomes Prevention Evaluation (HOPE).
View Article and Find Full Text PDFLong-term cardiovascular risks and the impact of statin treatment on socioeconomic inequalities: a microsimulation model.
Br J Gen Pract
March 2024
Health Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London; associate professor and senior health economist, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Background: UK cardiovascular disease (CVD) incidence and mortality have declined in recent decades but socioeconomic inequalities persist.
Aim: To present a new CVD model, and project health outcomes and the impact of guideline-recommended statin treatment across quintiles of socioeconomic deprivation in the UK.
Design And Setting: A lifetime microsimulation model was developed using 117 896 participants in 16 statin trials, 501 854 UK Biobank (UKB) participants, and quality-of-life data from national health surveys.
The Self-Fulfilling Process of Clinical Race Correction: The Case of Eighth Joint National Committee Recommendations.
Health Equity
November 2023
Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, California, USA.
There is growing attention to how unfounded beliefs about biological differences between racial groups affect biomedical research and health care, in part, through race adjustment in clinical tools. We develop a case study of the Eighth Joint National Committee (JNC 8)'s 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults, which recommends a distinct initial hypertension treatment for Black versus nonblack patients. We analyze the historical context, study design, and racialized findings of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) that informed development of the guideline.
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