Most Read Articles
3 days ago
Higher circulating levels of docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA) appear to be protective against incident atherothrombotic and cardioembolic strokes, respectively, according to a recent study.
Roshini Claire Anthony, 5 days ago

The prevalence of resistant hypertension may be lower than expected, particularly once pseudo-resistant hypertension due to treatment nonadherence is taken into account, according to a presentation at the recent APCH 2017.

Pank Jit Sin, 07 Jan 2015

Cardiovascular diseases (CVD) have been the main cause of death in the Malaysian population since 2007. This trend has continued, with the number of people dying from CVD-related causes increasing year on year. 

Tristan Manalac, 5 days ago
Administration of a long-acting medication at the time that is most suitable for maximum patient compliance is the best approach in controlling blood pressure, said Dr. Trefor Morgan at the recently concluded 13th Asian-Pacific Congress of Hypertension (APCH 2017), held at the Suntec Singapore Convention and Exhibition Centre.

Antihypertensive drug discontinuation tied to increased AMI risk

05 Aug 2017

Discontinuation of antihypertensive drugs appears to have a detrimental effect, with a recent study reporting that the risk of acute myocardial infarction (AMI) substantially increases after more than 90 days of discontinuation.

Researchers conducted a nested–control study including 1,245 patients hospitalized for their first AMI and 4,994 controls who had not been hospitalized. The risk of AMI was analysed by status of antihypertensive use: current users and discontinuers. Discontinuers were further divided into three according to the recency of discontinuation: recent discontinuers (≤90 days), intermediate-term discontinuers (91 to 180 days) and long-term discontinuers (>180 days).

Results showed that compared with current antihypertensive users, discontinuers were at significantly higher risk of developing AMI, regardless of time since discontinuation. The adjusted odds ratios were 1.54 (95 percent CI, 1.25 to 1.91; p<0.0005) with discontinuation of beta blockers, 2.25 (1.53 to 3.30; p<0.0005) with discontinuation of calcium channel blockers (CCBs) and 1.76 (1.24 to 2.48; p=0.002) with discontinuation of diuretics.

The risk of AMI further increased among long-term discontinuers (beta-blockers, CCBs, angiotensin-converting enzyme inhibitors and diuretics) and intermediate-term discontinuers (beta-blockers and CCBs) relative to current users.

No difference in AMI risk was observed between recent discontinuers and current users.

Researchers noted that the increased AMI risk after discontinuation of antihypertensive drugs is most likely a result of uncontrolled rebound hypertension in patients who discontinued their medications.

Other factors that may be involved include increases in myocardial oxygen requirements, sympathetic tone, circulating catecholamines, sensitivity of receptors to catecholamines, renin–angiotensin system activity, and platelet adhesiveness and aggregation, they added.

The present data underscore the importance of persistence to antihypertensive drug therapy to reduce the risk of AMI in patients with hypertension, researchers said.

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Most Read Articles
3 days ago
Higher circulating levels of docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA) appear to be protective against incident atherothrombotic and cardioembolic strokes, respectively, according to a recent study.
Roshini Claire Anthony, 5 days ago

The prevalence of resistant hypertension may be lower than expected, particularly once pseudo-resistant hypertension due to treatment nonadherence is taken into account, according to a presentation at the recent APCH 2017.

Pank Jit Sin, 07 Jan 2015

Cardiovascular diseases (CVD) have been the main cause of death in the Malaysian population since 2007. This trend has continued, with the number of people dying from CVD-related causes increasing year on year. 

Tristan Manalac, 5 days ago
Administration of a long-acting medication at the time that is most suitable for maximum patient compliance is the best approach in controlling blood pressure, said Dr. Trefor Morgan at the recently concluded 13th Asian-Pacific Congress of Hypertension (APCH 2017), held at the Suntec Singapore Convention and Exhibition Centre.