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Prevention And Treatment of Hypertension With Algorithm-based therapy (PATHWAY) number 2: protocol for a randomised crossover trial to determine optimal treatment for drug-resistant hypertension.

Williams B, MacDonald TM, Caulfield M, Cruickshank JK, McInnes G, Sever P, Webb DJ, Salsbury J, Morant S, Ford I, Brown MJ - BMJ Open (2015)

Bottom Line: A key secondary outcome is to determine whether plasma renin predicts the BP response to the different drugs.The study can also detect a 6 mm Hg difference in HBPM average systolic BP between each patient's best and second-best drug predicted by tertile of plasma renin.The study was initiated in May 2009 and results are expected in 2015.

View Article: PubMed Central - PubMed

Affiliation: Institute of Cardiovascular Sciences University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, London, UK.

No MeSH data available.


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Predicted probabilities model for plasma renin as the predictor of the best treatment option for resistant hypertension.
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BMJOPEN2015008951F2: Predicted probabilities model for plasma renin as the predictor of the best treatment option for resistant hypertension.

Mentions: The main secondary objective is to use plasma renin measurements to evaluate an ‘α, β, Δ’ rule for the selection of the fourth-line drug for patients with drug-resistant hypertension (see secondary objectives above). The hypothesis is that plasma renin (measured on a background of 3 drugs, ie, A+C+D), will predict the most effective fourth-line drug. We shall identify the best treatment for each patient, that is, the one on which they achieved the lowest BP. This is a categorical response and we shall use a logistic model to estimate the probability of each treatment being declared the best as a function of baseline renin. Superimposed plots of these probabilities (see figure 2) will show the range of renin values for which each treatment is most likely to be the best choice. We will also, in the same way, evaluate haemodynamic parameters indicative of sodium retention and volume status, that is, cardiac output, peripheral resistance and bioimpedance as predictors of the best fourth-line treatment among the three active treatments. An additional end point will be analyses of relationships between genetic factors and pharmacodynamic responses.


Prevention And Treatment of Hypertension With Algorithm-based therapy (PATHWAY) number 2: protocol for a randomised crossover trial to determine optimal treatment for drug-resistant hypertension.

Williams B, MacDonald TM, Caulfield M, Cruickshank JK, McInnes G, Sever P, Webb DJ, Salsbury J, Morant S, Ford I, Brown MJ - BMJ Open (2015)

Predicted probabilities model for plasma renin as the predictor of the best treatment option for resistant hypertension.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4538257&req=5

BMJOPEN2015008951F2: Predicted probabilities model for plasma renin as the predictor of the best treatment option for resistant hypertension.
Mentions: The main secondary objective is to use plasma renin measurements to evaluate an ‘α, β, Δ’ rule for the selection of the fourth-line drug for patients with drug-resistant hypertension (see secondary objectives above). The hypothesis is that plasma renin (measured on a background of 3 drugs, ie, A+C+D), will predict the most effective fourth-line drug. We shall identify the best treatment for each patient, that is, the one on which they achieved the lowest BP. This is a categorical response and we shall use a logistic model to estimate the probability of each treatment being declared the best as a function of baseline renin. Superimposed plots of these probabilities (see figure 2) will show the range of renin values for which each treatment is most likely to be the best choice. We will also, in the same way, evaluate haemodynamic parameters indicative of sodium retention and volume status, that is, cardiac output, peripheral resistance and bioimpedance as predictors of the best fourth-line treatment among the three active treatments. An additional end point will be analyses of relationships between genetic factors and pharmacodynamic responses.

Bottom Line: A key secondary outcome is to determine whether plasma renin predicts the BP response to the different drugs.The study can also detect a 6 mm Hg difference in HBPM average systolic BP between each patient's best and second-best drug predicted by tertile of plasma renin.The study was initiated in May 2009 and results are expected in 2015.

View Article: PubMed Central - PubMed

Affiliation: Institute of Cardiovascular Sciences University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, London, UK.

No MeSH data available.


Related in: MedlinePlus