| Titre : | Thiazide diuretics and the initiation of anti-gout therapy. (1997) |
| Auteurs : | J.H. GURWITZ ; J. AVORN ; R.L. BOHN ; R.J. GLYNN ; S.C. KALISH ; H. MOGUN ; M. MONANE ; Program For The Analysis of Clinical Strategies. The Divisions of Gerontology and Preventive Medicine. Department of Medicine. Brigham and Women's Hospital and Harvard Medical School. Boston Massachusetts. USA |
| Type de document : | Article |
| Dans : | Journal of clinical epidemiology (vol. 50, n° 8, 1997) |
| Pagination : | 953-959 |
| Langues: | Anglais |
| Mots-clés : | Hypertension artérielle ; Goutte ; Epidémiologie ; Thérapeutique médicamenteuse ; Thérapeutique ; Homme ; Acide urique ; Etats Unis ; Amérique du Nord ; Amérique ; Appareil circulatoire [pathologie] ; Métabolisme [pathologie] ; Système ostéoarticulaire [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST 8XR0xXkD. Diffusion soumise à autorisation]. While physiologic and epidemiologic evidence link diuretic therapy with hyperuricemia, no previous study has quantified the risk for initiation of treatment specific for hyperuricemia or gout among elderly patients taking thiazide diuretics. We performed a retrospective cohort study of 9249 enrollees aged 65 or older in the New Jersey Medicaid program who were newly started on an antihypertensive medication from November 1981 through February 1989 and who had no prior use of anti-gout therapy (allopurinol, colchicine, or a uricosuric) during the preceding one-year period. We used Cox proportional hazards analysis to determine the risk for the initiation of anti-gout therapy in patients using various antihypertensive treatment regimens relative to no antihypertensive exposure. Patient follow-up extended for up to two years. Antihypertensive exposure was characterized over the entire period of follow-up according to the following categories : thiazide diuretic therapy alone ; non-thiazide antihypertensive therapy ; thiazide diuretic therapy in combination with any non-thiazide antihypertensive agent (s) ; and no antihypertensive use. Antihypertensive exposure was entered into the model as a time-varying covariate. Estimates of risk were adjusted for age, sex, race, nursing home residence, number of prescriptions filled, intensity of physician use, hospitalization history, and year of antihypertensive treatment initiation. (...) |
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