Bunk, B.A.A. (2012) Stoppen met bètablokkers bij diabetes mellitus type 2-patiënten van 65 jaar en ouder: welke patiënten stoppen en wat zijn de gevolgen van stoppen? thesis, Medicine.
Full text available on request.Abstract
-Background: The appropriateness of continued use of preventive cardiovascular medication is doubted in some elderly patients. Already known is that type 2 diabetes mellitus (T2DM) patients sometimes stop using part of their medication regime. -Research Goals: We want to determine if patient characteristics can predict stopping or continuing use of bètablockers. After identifying the patients who have stopped for at least 180 days in our population, we want to investigate what the effects of stopping are on hard outcome measures (mortality and hypertension related complications) and on blood pressure. -Methods: T2DM-patients older than 65 years of age are included in our research. The influence of clinical and demographic factors, medicine use and of comorbidity on stopping is analyzed by using logistic regression. Regression analysis is also used to test the influence of stopping on hard outcome measures. In these analyses patients who stopped using bètablockers are compared to those continuing user and to patients who never used antihypertensive medication despite having a high systolic blood pressure. The difference in the change in blood pressure is calculated with Mann-Whitney tests. -Results: 4627 patients were eligible for evaluation. 86 patients stopped using bètablockers, 1513 patients kept on using them and 278 patients had a high systolic blood pressured but did not receive antihypertensive therapy. The remaining 2750 patients were not further analyzed. Most of the analyzed patients were 74 years or younger and most of the patients who stopped were young. Multivariable analyses show that the use of lipid lowering medication, the use of antidiabetics and/or insulin and having higher triglyceride values were associated with ongoing use of bètablockers. Stopping them does not seem to have effect on hard outcome measures. The blood pressure does not change significantly after stopping. -Conclusions: Patients who use more chronic medication are less likely to stop using bètablockers. However, stopping bètablockers is possible without being associated with negative effects on hard outcome measures or causing negative effects on the blood pressure.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Denig, Dr. P. and Universitair Medisch Centrum Groningen, afdeling Klinische F |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2388 |
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