Clinical Medicine Insights. Cardiology最新文献

{"title":"Self-Care Interventions That Reduce Hospital Readmissions in Patients With Heart Failure; Towards the Identification of Change Agents.","authors":"S R Toukhsati,&nbsp;T Jaarsma,&nbsp;A S Babu,&nbsp;A Driscoll,&nbsp;D L Hare","doi":"10.1177/1179546819856855","DOIUrl":"https://doi.org/10.1177/1179546819856855","url":null,"abstract":"<p><p>Unplanned hospital readmissions are the most important, preventable cost in heart failure (HF) health economics. Current professional guidelines recommend that patient self-care is an important means by which to reduce this burden. Patients with HF should be engaged in their care such as by detecting, monitoring, and managing their symptoms. A variety of educational and behavioural interventions have been designed and implemented by health care providers to encourage and support patient self-care. Meta-analyses support the use of self-care interventions to improve patient self-care and reduce hospital readmissions; however, efficacy is variable. The aim of this review was to explore methods to achieve greater clarity and consistency in the development and reporting of self-care interventions to enable 'change agents' to be identified. We conclude that advancement in this field requires more explicit integration and reporting on the behaviour change theories that inform the design of self-care interventions and the selection of behaviour change techniques. The systematic application of validated checklists, such as the Theory Coding Scheme and the CALO-RE taxonomy, will improve the systematic testing and refinement of interventions to enable 'change agent/s' to be identified and optimised.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2019-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819856855","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37344163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Predictors of Statin Treatment Among Patients With Chronic Heart Failure at a Tertiary-Care Center in Thailand.","authors":"Pattamawan Kosuma, Arom Jedsadayanmata","doi":"10.1177/1179546819855656","DOIUrl":"10.1177/1179546819855656","url":null,"abstract":"<p><strong>Background: </strong>Statins play important roles in the prevention of atherosclerotic vascular diseases; however, their beneficial effects in patients with chronic heart failure (CHF) are uncertain. This study aimed to investigate the prevalence and predictors of treatment with statins to better understand their prescribing patterns in CHF patients.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in patients with first-time diagnoses of CHF receiving care in the outpatient clinics affiliated with a tertiary-care teaching hospital in Thailand. Data were retrieved from electronic claims database. Multivariable logistic regression was used to identify independent predictors of treatment with statins.</p><p><strong>Results: </strong>A total of 3445 patients were included in this study. Among them, 1908 (55.4%) were prescribed statins, with most of them (89.7%) receiving simvastatin 20 mg daily. Factors independently associated with the statin treatment include the following: being male (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.02-1.44, <i>P</i> = .03); diagnoses of dyslipidemia (OR = 4.88, 95% CI = 3.88-6.14, <i>P</i> < .001), ischemic heart disease (OR = 2.71, 95% CI = 2.18-3.36, <i>P</i> < .001), diabetes (OR = 1.95, 95% CI = 1.55-2.46, <i>P</i> < .001), or cerebrovascular disease (OR = 1.64, 95% CI = 1.12-2.40, <i>P</i> = .01); and receipt of angiotensin-converting enzyme inhibitors (OR = 3.44, 95% CI = 2.87-4.13, <i>P</i> < .001), aspirin (OR = 2.79, 95% CI = 2.30-3.40, <i>P</i> < .001), non-dihydropyridine calcium channel blockers (OR = 2.35, 95% CI = 1.30-4.24, <i>P</i> = .004), organic nitrates (OR = 2.04, 95% CI = 1.16-3.58, <i>P</i> = .01), beta-blockers (OR = 1.51, 95% CI = 1.23-1.84, <i>P</i> < .001), and digoxin (OR = 0.65, 95% CI = 0.50-0.86, <i>P</i> = .002).</p><p><strong>Conclusions: </strong>Statins were prescribed to more than half of the newly diagnosed CHF patients. Independent predictors of statin treatments include hypercholesterolemia and comorbidities indicative of high atherosclerotic vascular risk as well as drugs recommended as cardiovascular protective therapy for CHF patients.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/9f/10.1177_1179546819855656.PMC6558538.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37344161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Era for Rotational Atherectomy: An Australian Perspective.","authors":"Paul Bamford,&nbsp;Michael David Parkinson,&nbsp;Brendan Gunalingam,&nbsp;Michael David,&nbsp;George Tat-Ming Lau","doi":"10.1177/1179546819852070","DOIUrl":"https://doi.org/10.1177/1179546819852070","url":null,"abstract":"<p><strong>Background: </strong>Rotational atherectomy (RA) has been used in percutaneous coronary intervention (PCI) for 30 years. With advances in technology, this observational study looks at how rates of RA have changed over the past decade in Australia in relation to PCI and coronary artery bypass graft (CABG) rates.</p><p><strong>Methods: </strong>Retrospective analysis of RA, PCI, and CABG rates per Australian state from Australian Government Department of Human Services' data on Medicare items from 2007 to 2017 was carried out.</p><p><strong>Results: </strong>There were 149 RA procedures in 2007, increasing to 452 in 2017. Rotational atherectomy accounted for 0.67% of PCI procedures in 2007, increasing to 1.48% in 2018 (+0.81%, 95% confidence interval [CI] = [0.64%-0.91%]; <i>P</i> < .001). Most of this increase has come from procedures in New South Wales (441% increase). Australian PCI rate increased from 22 301 to 30 480. Rate of CABG decreased from 5418 to 5206.</p><p><strong>Conclusions: </strong>From 2007 to 2017, rates of RA trebled in Australia. This is despite stable rates of PCI and a fall in rates of CABG. There are several clinical explanations for this trend.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2019-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819852070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37344160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Viscosity and NLR in Young Subjects with Myocardial Infarction: Evaluation at the Initial Stage and at 3 and 12 Months.","authors":"Gregorio Caimi,&nbsp;Maria Montana,&nbsp;Giuseppe Andolina,&nbsp;Eugenia Hopps,&nbsp;Rosalia Lo Presti","doi":"10.1177/1179546819849428","DOIUrl":"https://doi.org/10.1177/1179546819849428","url":null,"abstract":"<p><p>In the \"Sicilian study on juvenile myocardial infarction,\" we had evaluated plasma viscosity (PV) and neutrophil/lymphocyte ratio (NLR) in patients with acute myocardial infarction (AMI) at the age of ⩽45 years. Now, we examined the relationship between these 2 parameters in 120 subjects (109 men and 11 women) aged ⩽45 years with recent AMI. The patients were classified according to the number of cardiovascular risk factors, the electrocardiographic criteria (ST-segment elevation myocardial infarction [STEMI] or non-ST-segment elevation myocardial infarction [NSTEMI]), and the extent of coronary stenosis, evaluated with coronary angiography. On fasting venous blood, we measured PV at the shear rate of 450 s^-1 and NLR. The control group included 50 healthy subjects (mean age = 35.1 ± 7.8 years). At the initial stage, PV and NLR were significantly increased in comparison with controls. Subdividing AMI patients according to the median value of NLR, in the group with high NLR PV was significantly higher, whereas subdividing the patients according to the PV median value, NLR was not different between the 2 groups; 3 and 12 months after AMI, we observed only a significant decrease in NLR. Only PV was discriminant regarding the cardiovascular complications registered during an 18-month follow-up. The evaluation of PV may be of prognostic value in juvenile AMI.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2019-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819849428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37339181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities for Care Optimization and Hospitalization Reduction for Older Persons With Heart Failure.","authors":"Nahid Azad","doi":"10.1177/1179546819841597","DOIUrl":"10.1177/1179546819841597","url":null,"abstract":"Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Clinical Medicine Insights: Cardiology Volume 13: 1–3 © The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1 7954681984 597","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819841597","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37255449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Genetically Guided Mathematical Prediction and the Blood Pressure Response to Pharmacotherapy in Hypertension Patients.","authors":"Eli F Kelley,&nbsp;Thomas P Olson,&nbsp;Timothy B Curry,&nbsp;Ryan Sprissler,&nbsp;Eric M Snyder","doi":"10.1177/1179546819845883","DOIUrl":"https://doi.org/10.1177/1179546819845883","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine the effectiveness of a simple algorithm to mathematically predict a patients' response to blood pressure (BP) therapy using functional genes in the 3 major organ systems involved in hypertension.</p><p><strong>Methods: </strong>Eighty-six patients with controlled hypertension completed 1 study visit consisting of a buccal swab collection, measurement of office BP, and a medical chart review for BP history. Genes in the analysis included 14 functional alleles in 11 genes. These genotypes were mathematically summed per organ system to determine whether a patient would likely respond to target therapy.</p><p><strong>Results: </strong>Patients recommended to and taking a diuretic had significantly higher rates of control (<120/<80) than patients recommended but not taking this drug class (0.2 ± 0.1 and 0.03 ± 0.03, respectively). Furthermore, there was a difference between patients genetically recommended and taking an angiotensin receptor blocker (ARB) vs patients recommended but not taking an ARB for the lowest diastolic blood pressure (DBP) and mean arterial pressure (MAP) recorded in the past 2 years (DBP = 66.2 ± 2.9 and 75.3 ± 1.7, MAP = 82.3 ± 2.8 and 89.3 ± 1.5, respectively). In addition, there was a nonsignificant trend for greater reductions in ΔSBP, ΔDBP, and ΔMAP in patients on recommended drug class for beta-blockers, diuretics, and angiotensin II receptor blockers vs patients not on these classes.</p><p><strong>Conclusion: </strong>The present study suggests that simple mathematical weighting of functional genotypes known to control BP may be ineffective in predicting control. This study demonstrates the need for a more complex, weighted, multigene algorithm to more accurately predict BP therapy response.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2019-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819845883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37255450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Myocardial Bridge: Potential Influences on the Coronary Artery Vasculature.","authors":"Hiroki Teragawa,&nbsp;Chikage Oshita,&nbsp;Tomohiro Ueda","doi":"10.1177/1179546819846493","DOIUrl":"https://doi.org/10.1177/1179546819846493","url":null,"abstract":"<p><p>A myocardial bridge (MB) is an anatomical abnormality of the coronary artery and is characterized by the systolic narrowing of the epicardial coronary artery caused by myocardial compression during systole. An MB is frequently observed on cardiac computed tomography or coronary angiography and generally appears to be harmless in the majority of patients. However, the presence of MB is reportedly associated with abnormalities of the cardiovascular system, including coronary artery diseases, arrhythmia, certain types of cardiomyopathy, and cardiac death, indicating that MB serves a pivotal role in the occurrence and/or development of such cardiovascular events. Recently, there has been an increasing interest in the coexistence of MB and coronary spasm in research due to opposing aspects regarding their treatments. For example, monotherapy using β-blockers, which are effective in patients with MB, may worsen symptoms in patients with coronary spasm. By contrast, nitroglycerin, which is an effective treatment option for coronary spasm, may worsen symptoms in patients with MB. This review focuses on the pathophysiology and diagnosis of MB and MB-related cardiovascular diseases, including coronary spasm, and on the treatment strategies for MB.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819846493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37225643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Soluble ST2 and Adverse Left Ventricular Remodeling in Patients With ST-Segment Elevation Myocardial Infarction.","authors":"Maria Kercheva,&nbsp;Tamara Ryabova,&nbsp;Anna Gusakova,&nbsp;Tatiana E Suslova,&nbsp;Vyacheslav Ryabov,&nbsp;Rostislav S Karpov","doi":"10.1177/1179546819842804","DOIUrl":"https://doi.org/10.1177/1179546819842804","url":null,"abstract":"<p><strong>Objective: </strong>To assess the dynamics of serum levels of soluble isoform of suppression of tumorigenicity 2 (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) and their correlations with the development of adverse left ventricular remodeling (LVR) through 6 months in patients with primary myocardial infarction with ST-segment elevation (STEMI).</p><p><strong>Methods: </strong>Subjects were 31 patients with STEMI (median age: 58 years), who underwent percutaneous coronary intervention (PCI) during the first 24 hours of the onset of myocardial infarction (MI). Blood samples and parameters of echocardiography were assessed at days 1, 3, 7, and 14 and 6 months after STEMI.</p><p><strong>Results: </strong>Serum levels of sST2 and NT-proBNP decreased during the 6-month period. Levels of sST2 decreased by 48% from admission to day 7, and levels of NT-proBNP decreased by 40% from day 7 to 6 months after STEMI. Serum levels of sST2 at day 1 (<i>r</i> = 0.5, <i>P</i> < .05) and day 3 (<i>r</i> = 0.4, <i>P</i> < .05) were associated with adverse LVR by 6 months after STEMI. Logistic regression analysis showed that a high concentration of sST2 at day 7 increased the risk of adverse LVR (95% confidence interval [CI], 0.5-0.9; areas under curve [AUC] = 0.8; <i>P</i> = .002), with 92% sensitivity and 70% specificity. A multivariate analysis model revealed that adverse LVR was associated with the level of sST2 (<i>P</i> = .003) and with complete revascularization (<i>P</i> = .01) at the admission.</p><p><strong>Conclusions: </strong>The dynamics of serum levels of sST2 and NT-proBNP were different. The level of sST2 normalized by the 7th day; NT-proBNP decreased only by the end of the 6-month period after MI. Increased serum levels of sST2 by the 7th day of MI were associated with the development of adverse LVR by the end of the 6-month period.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2019-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179546819842804","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37383714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes of Patients with Acute Coronary Syndrome Admitted to Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.","authors":"Kassahun Bogale, Desalew Mekonnen, Teshome Nedi, Minyahil Alebachew Woldu","doi":"10.1177/1179546819839417","DOIUrl":"10.1177/1179546819839417","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) refers to a spectrum of conditions compatible with acute myocardial ischemia and/or infarction that are usually due to an abrupt reduction in coronary blood flow.</p><p><strong>Objective: </strong>The objective of the study was to assess the treatment outcome and associated factors for ACS.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted from January 1, 2012 to December 31, 2014.</p><p><strong>Results: </strong>Of 124 ACS patients who were admitted during the 3 years' period, 90 (72.6%) were diagnosed with ST segment elevation myocardial infarction (STEMI). The mean age was 56.3 ± 13.7 years. The average length of hospital stay was 9.77 ± 6.42 days. The average time from onset of ACS symptoms to presentation in the emergency department was 3.8 days (91.7 hours). In about 76 (61.3%) patients, hypertension was the leading risk factor for development of ACS, and 36.4% of ACS patients were either Killip class III or IV. Biomarkers were measured for 118 (95.2%) patients, and 79.2% of patients had ejection fraction of less than 40% and 29.2% had less than 30%. In-hospital medication use includes loading dose of aspirin (79%), anticoagulants (77.4%), beta blockers (88.1%), statins (85.5%), morphine (12.9%), and nitrates (35.5%). The in-hospital mortality was 27.4%. The predictors for in-hospital mortality were age (<i>P</i> = .042), time from symptom onset to presentation (<i>P</i> = .001), previous history of hypertension (<i>P</i> = .025), being Killip class III and IV (<i>P</i> = .001), and STEMI diagnosis (<i>P</i> = .005).</p><p><strong>Conclusions: </strong>The medical management of ACS patients in Tikur Anbessa Specialized Hospital (TASH) was in line with the recommendations of international guidelines but in-hospital mortality was extremely high (27.4%).</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2019-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/30/10.1177_1179546819839417.PMC6472164.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37361663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Antihypertensive Drug Utilization among US Adults with Diabetes and Comorbid Hypertension: The National Health and Nutrition Examination Survey 1999-2014.","authors":"Anna Gu, Shireen N Farzadeh, You Jin Chang, Andrew Kwong, Sum Lam","doi":"10.1177/1179546819839418","DOIUrl":"10.1177/1179546819839418","url":null,"abstract":"<p><strong>Background: </strong>Diabetes and hypertension are the 2 leading risk factors for suboptimal cardiovascular and renal outcomes. These 2 conditions often coexist and can benefit from antihypertensive therapy, which may lead to blood pressure control and reduced risk for nephropathy (as evidenced by albuminuria).</p><p><strong>Objective: </strong>To quantify the trends of antihypertensive drug use and to assess the impact of antihypertensive treatment on the prevalence of blood pressure control and albuminuria, among US adults with coexisting diabetes and hypertension.</p><p><strong>Methods: </strong>In this serial cross-sectional study, we analyzed data from the 1999-2014 National Health and Nutrition Examination Survey (N = 3586). We determine the prevalence of antihypertensive use, drug classes used, and their association with blood pressure control and albuminuria.</p><p><strong>Results: </strong>During the study period, the study population experienced substantial increase in antihypertensive treatment (from 84.6% in 1999-2002 to 90.1% in 2011-2014, <i>P_trend</i>  < .01) and blood pressure control (from 37.1% to 46.9%, <i>P_trend</i>  < .01) and decrease in albuminuria (from 39.1% to 31.3%, <i>P_trend</i>  = .02). These trends were particularly pronounced in the subgroups using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers. In multivariate analysis, Blacks, Hispanics, and males were found more likely to have albuminuria than their respective counterparts. Achieving blood pressure control (odds ratio = 0.40, 95% confidence interval [CI]: 0.32-0.49) was associated with lower rates of albuminuria.</p><p><strong>Conclusion and relevance: </strong>Despite continued improvement in antihypertensive therapy, the burden of uncontrolled blood pressure and albuminuria remains substantial among US adults with diabetes and hypertension. Tailoring pharmacotherapy based on patient characteristics and comorbidities is needed to further improve these outcomes.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2019-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/8a/10.1177_1179546819839418.PMC6463235.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37180426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}