Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety.
<h4>Background</h4>Lisinopril and losartan manufacturer labels recommend twice-daily dosing (BID) if once-daily (QDay) is insufficient to lower blood pressure (BP).<h4>Methods and results</h4>Retrospective cohort study of patients taking QDay lisinopril and losartan who exper...
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| Format: | Article |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0243371&type=printable |
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| author | Catherine G Derington Jordan B King Thomas Delate Sheila R Botts Miranda Kroehl David P Kao Katy E Trinkley |
| author_facet | Catherine G Derington Jordan B King Thomas Delate Sheila R Botts Miranda Kroehl David P Kao Katy E Trinkley |
| author_sort | Catherine G Derington |
| collection | DOAJ |
| description | <h4>Background</h4>Lisinopril and losartan manufacturer labels recommend twice-daily dosing (BID) if once-daily (QDay) is insufficient to lower blood pressure (BP).<h4>Methods and results</h4>Retrospective cohort study of patients taking QDay lisinopril and losartan who experienced a dose-doubling (index date). A text-processing tool categorized BID and QDay groups at the index date based on administration instructions. We excluded: pregnant/hospice, regimens other than BID/QDay, and without BP measurements -6 months/+12 months of the index date. The most proximal BP measurements -6 months and +2 weeks to 12 months of the index date were used to evaluate BP differences. Propensity scores were generated, and differences in BP and adverse events (angioedema, acute kidney injury, hyperkalemia) between BID/QDay groups were analyzed within dosing cohorts using inverse propensity of treatment-weighted regression models. Of 11,210 and 6,051 patients who met all criteria for lisinopril and losartan, 784 (7.0%) and 453 (7.5%) were taking BID, respectively. BID patients were older and had higher comorbidity and medication burdens. There were no differences in systolic/diastolic BP between BID and QDay, with absolute differences in mean systolic BP ranging from -1.8 to 0.7 mmHg and diastolic BP ranging from -1.1 to 0.1 mmHg (all 95% confidence intervals [CI] cross 0). Lisinopril 10mg BID was associated with an increased odds of angioedema compared to lisinopril 20mg QDay (odds ratio 2.27, 95%CI 1.13-4.58).<h4>Conclusions</h4>Adjusted models do not support improved effectiveness or safety of BID lisinopril and losartan. |
| format | Article |
| id | doaj-art-e08f8dcbeafa44a58d3e9961c141a874 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-e08f8dcbeafa44a58d3e9961c141a8742025-08-20T03:44:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011512e024337110.1371/journal.pone.0243371Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety.Catherine G DeringtonJordan B KingThomas DelateSheila R BottsMiranda KroehlDavid P KaoKaty E Trinkley<h4>Background</h4>Lisinopril and losartan manufacturer labels recommend twice-daily dosing (BID) if once-daily (QDay) is insufficient to lower blood pressure (BP).<h4>Methods and results</h4>Retrospective cohort study of patients taking QDay lisinopril and losartan who experienced a dose-doubling (index date). A text-processing tool categorized BID and QDay groups at the index date based on administration instructions. We excluded: pregnant/hospice, regimens other than BID/QDay, and without BP measurements -6 months/+12 months of the index date. The most proximal BP measurements -6 months and +2 weeks to 12 months of the index date were used to evaluate BP differences. Propensity scores were generated, and differences in BP and adverse events (angioedema, acute kidney injury, hyperkalemia) between BID/QDay groups were analyzed within dosing cohorts using inverse propensity of treatment-weighted regression models. Of 11,210 and 6,051 patients who met all criteria for lisinopril and losartan, 784 (7.0%) and 453 (7.5%) were taking BID, respectively. BID patients were older and had higher comorbidity and medication burdens. There were no differences in systolic/diastolic BP between BID and QDay, with absolute differences in mean systolic BP ranging from -1.8 to 0.7 mmHg and diastolic BP ranging from -1.1 to 0.1 mmHg (all 95% confidence intervals [CI] cross 0). Lisinopril 10mg BID was associated with an increased odds of angioedema compared to lisinopril 20mg QDay (odds ratio 2.27, 95%CI 1.13-4.58).<h4>Conclusions</h4>Adjusted models do not support improved effectiveness or safety of BID lisinopril and losartan.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0243371&type=printable |
| spellingShingle | Catherine G Derington Jordan B King Thomas Delate Sheila R Botts Miranda Kroehl David P Kao Katy E Trinkley Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. PLoS ONE |
| title | Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. |
| title_full | Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. |
| title_fullStr | Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. |
| title_full_unstemmed | Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. |
| title_short | Twice-daily versus once-daily lisinopril and losartan for hypertension: Real-world effectiveness and safety. |
| title_sort | twice daily versus once daily lisinopril and losartan for hypertension real world effectiveness and safety |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0243371&type=printable |
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