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Impacts of center and clinical factors in antihypertensive medication use after kidney transplantation

dc.contributor.authorKoraishy, Farrukh M.
dc.contributor.authorYamout, Hala
dc.contributor.authorNaik, Abhijit S.
dc.contributor.authorZhang, Zidong
dc.contributor.authorSchnitzler, Mark A.
dc.contributor.authorOuseph, Rosemary
dc.contributor.authorLam, Ngan N.
dc.contributor.authorDharnidharka, Vikas R.
dc.contributor.authorAxelrod, David
dc.contributor.authorHess, Gregory P.
dc.contributor.authorSegev, Dorry L.
dc.contributor.authorKasiske, Bertram L.
dc.contributor.authorLentine, Krista L.
dc.date.accessioned2020-04-02T18:39:29Z
dc.date.availableWITHHELD_12_MONTHS
dc.date.available2020-04-02T18:39:29Z
dc.date.issued2020-03
dc.identifier.citationKoraishy, Farrukh M.; Yamout, Hala; Naik, Abhijit S.; Zhang, Zidong; Schnitzler, Mark A.; Ouseph, Rosemary; Lam, Ngan N.; Dharnidharka, Vikas R.; Axelrod, David; Hess, Gregory P.; Segev, Dorry L.; Kasiske, Bertram L.; Lentine, Krista L. (2020). "Impacts of center and clinical factors in antihypertensive medication use after kidney transplantation." Clinical Transplantation 34(3): n/a-n/a.
dc.identifier.issn0902-0063
dc.identifier.issn1399-0012
dc.identifier.urihttps://hdl.handle.net/2027.42/154651
dc.description.abstractHypertension guidelines recommend calcium channel blockers (CCBs), thiazide diuretics, and angiotensin‐converting‐enzyme inhibitors/angiotensin receptor blockers (ACEi/ARBs) as first‐line agents to treat hypertension. Hypertension is common among kidney transplant (KTx) recipients, but data are limited regarding patterns of antihypertensive medication (AHM) use in this population. We examined a novel database that links national registry data for adult KTx recipients (age > 18 years) with AHM fill records from a pharmaceutical claims warehouse (2007‐2016) to describe use and correlates of AHM use during months 7‐12 post‐transplant. For patients filling AHMs, individual agents used included: dihydropyridine (DHP) CCBs, 55.6%; beta‐blockers (BBs), 52.8%; diuretics, 30.0%; ACEi/ARBs, 21.1%; non‐DHP CCBs, 3.0%; and others, 20.1%. Both BB and ACEi/ARB use were significantly lower in the time period following the 2014 Eighth Joint National Committee (JNC‐8) guidelines (2014‐2016), compared with an earlier period (2007‐2013). The median odds ratios generated from case‐factor adjusted models supported variation in use of ACEi/ARBs (1.51) and BBs (1.55) across transplant centers. Contrary to hypertension guidelines for the general population, KTx recipients are prescribed relatively more BBs and fewer ACEi/ARBs. The clinical impact of this AHM prescribing pattern warrants further study.
dc.publisherWiley Periodicals, Inc.
dc.subject.otherkidney transplant
dc.subject.otherpharmacoepidemiology
dc.subject.otherpractice patterns
dc.subject.otherantihypertensive medications
dc.titleImpacts of center and clinical factors in antihypertensive medication use after kidney transplantation
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelMedicine (General)
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/154651/1/ctr13803.pdf
dc.description.bitstreamurlhttps://deepblue.lib.umich.edu/bitstream/2027.42/154651/2/ctr13803_am.pdf
dc.identifier.doi10.1111/ctr.13803
dc.identifier.sourceClinical Transplantation
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dc.owningcollnameInterdisciplinary and Peer-Reviewed


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