Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety.
Aged
Aged, 80 and over
Angioedema
/ chemically induced
Antihypertensive Agents
/ administration & dosage
Blood Pressure
/ drug effects
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Hypertension
/ diagnosis
Lisinopril
/ administration & dosage
Losartan
/ administration & dosage
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
08
2020
accepted:
19
11
2020
entrez:
3
12
2020
pubmed:
4
12
2020
medline:
26
1
2021
Statut:
epublish
Résumé
Lisinopril and losartan manufacturer labels recommend twice-daily dosing (BID) if once-daily (QDay) is insufficient to lower blood pressure (BP). Retrospective cohort study of patients taking QDay lisinopril and losartan who experienced a dose-doubling (index date). A text-processing tool categorized BID and QDay groups at the index date based on administration instructions. We excluded: pregnant/hospice, regimens other than BID/QDay, and without BP measurements -6 months/+12 months of the index date. The most proximal BP measurements -6 months and +2 weeks to 12 months of the index date were used to evaluate BP differences. Propensity scores were generated, and differences in BP and adverse events (angioedema, acute kidney injury, hyperkalemia) between BID/QDay groups were analyzed within dosing cohorts using inverse propensity of treatment-weighted regression models. Of 11,210 and 6,051 patients who met all criteria for lisinopril and losartan, 784 (7.0%) and 453 (7.5%) were taking BID, respectively. BID patients were older and had higher comorbidity and medication burdens. There were no differences in systolic/diastolic BP between BID and QDay, with absolute differences in mean systolic BP ranging from -1.8 to 0.7 mmHg and diastolic BP ranging from -1.1 to 0.1 mmHg (all 95% confidence intervals [CI] cross 0). Lisinopril 10mg BID was associated with an increased odds of angioedema compared to lisinopril 20mg QDay (odds ratio 2.27, 95%CI 1.13-4.58). Adjusted models do not support improved effectiveness or safety of BID lisinopril and losartan.
Sections du résumé
BACKGROUND
Lisinopril and losartan manufacturer labels recommend twice-daily dosing (BID) if once-daily (QDay) is insufficient to lower blood pressure (BP).
METHODS AND RESULTS
Retrospective cohort study of patients taking QDay lisinopril and losartan who experienced a dose-doubling (index date). A text-processing tool categorized BID and QDay groups at the index date based on administration instructions. We excluded: pregnant/hospice, regimens other than BID/QDay, and without BP measurements -6 months/+12 months of the index date. The most proximal BP measurements -6 months and +2 weeks to 12 months of the index date were used to evaluate BP differences. Propensity scores were generated, and differences in BP and adverse events (angioedema, acute kidney injury, hyperkalemia) between BID/QDay groups were analyzed within dosing cohorts using inverse propensity of treatment-weighted regression models. Of 11,210 and 6,051 patients who met all criteria for lisinopril and losartan, 784 (7.0%) and 453 (7.5%) were taking BID, respectively. BID patients were older and had higher comorbidity and medication burdens. There were no differences in systolic/diastolic BP between BID and QDay, with absolute differences in mean systolic BP ranging from -1.8 to 0.7 mmHg and diastolic BP ranging from -1.1 to 0.1 mmHg (all 95% confidence intervals [CI] cross 0). Lisinopril 10mg BID was associated with an increased odds of angioedema compared to lisinopril 20mg QDay (odds ratio 2.27, 95%CI 1.13-4.58).
CONCLUSIONS
Adjusted models do not support improved effectiveness or safety of BID lisinopril and losartan.
Identifiants
pubmed: 33270787
doi: 10.1371/journal.pone.0243371
pii: PONE-D-20-26973
pmc: PMC7714357
doi:
Substances chimiques
Antihypertensive Agents
0
Lisinopril
E7199S1YWR
Losartan
JMS50MPO89
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0243371Subventions
Organisme : American Heart Association-American Stroke Association
ID : 19POST34380226
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002535
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Am J Manag Care. 2009 Jun 01;15(6):e22-33
pubmed: 19514806
EGEMS (Wash DC). 2014 Mar 24;2(1):1049
pubmed: 25848584
Int J Nephrol Renovasc Dis. 2013 Oct 11;6:223-7
pubmed: 24143121
Clin Hypertens. 2016 Mar 27;22:7
pubmed: 27019747
Appl Clin Inform. 2014 Aug 06;5(3):699-707
pubmed: 25298810
Stat Med. 1998 Apr 30;17(8):857-72
pubmed: 9595616
J Manag Care Spec Pharm. 2018 Jul;24(7):691-699
pubmed: 29345553
JAMA Intern Med. 2016 Apr;176(4):463-70
pubmed: 26954486
J Clin Hypertens (Greenwich). 2008 Feb;10(2):112-8
pubmed: 18259123
Am J Manag Care. 2012 Mar;18(3):139-46
pubmed: 22435907
Biometrics. 1996 Mar;52(1):286-90
pubmed: 8934597
J Clin Hypertens (Greenwich). 2005 Jun;7(6):372-5
pubmed: 16088303
Stat Med. 2010 Sep 10;29(20):2137-48
pubmed: 20108233
Arch Mal Coeur Vaiss. 1994 Nov;87(11):1423-9
pubmed: 7771888
Blood Press. 1998 Jan;7(1):53-9
pubmed: 9551878
Arch Intern Med. 1995 Feb 27;155(4):405-11
pubmed: 7848024
Clin Ther. 2002 Feb;24(2):302-16
pubmed: 11911560
J Clin Pharmacol. 1993 Sep;33(9):832-6
pubmed: 8227480
Vasc Health Risk Manag. 2010 Aug 09;6:449-55
pubmed: 20730060
J Gen Intern Med. 2019 Jun;34(6):839-845
pubmed: 30859504
J Hypertens. 1999 Jan;17(1):129-36
pubmed: 10100104
Lancet. 2012 Dec 15;380(9859):2224-60
pubmed: 23245609
Lancet. 2002 Dec 14;360(9349):1903-13
pubmed: 12493255
Pediatrics. 2019 Apr;143(4):
pubmed: 30842257
J Manag Care Spec Pharm. 2015 Nov;21(11):1025-31
pubmed: 26521114
Med Care. 2005 Nov;43(11):1130-9
pubmed: 16224307
Am J Hypertens. 2017 Oct 1;30(10):1008-1014
pubmed: 28531239
J Hum Hypertens. 2007 Jul;21(7):525-30
pubmed: 17460714
J Clin Hypertens (Greenwich). 2017 Sep;19(9):868-873
pubmed: 28439946
Value Health. 2010 Mar-Apr;13(2):273-7
pubmed: 19912596
Am J Hypertens. 1996 Jul;9(7):633-43
pubmed: 8806975
Multivariate Behav Res. 2011 May;46(3):399-424
pubmed: 21818162
J Hypertens. 1997 Dec;15(12 Pt 1):1511-8
pubmed: 9431859
J Cardiovasc Pharmacol. 1994;23 Suppl 5:S26-30
pubmed: 7609502
Patient Prefer Adherence. 2013 May 20;7:419-34
pubmed: 23737662
Lancet. 2004 Nov 6-12;364(9446):1684-9
pubmed: 15530629
Clin Ther. 1999 Mar;21(3):464-74
pubmed: 10321416
BMC Health Serv Res. 2006 Dec 15;6:161
pubmed: 17173686
Arch Intern Med. 2012 Nov 12;172(20):1582-9
pubmed: 23147456
J Hypertens. 1999 Nov;17(11):1627-31
pubmed: 10608477