Objective. This study was designed to assess the association between cardiovascular disease and the use of antihypertensive drugs in a diabetic population. / Design and setting. We conducted a case-control study nested within a cohort of 2499 subjects over 45 years old with diabetes and hypertension in Saskatchewan. / Outcomes. The main outcome measure was first hospitalization for cardiovascular disease. / Exposure definition. The main exposure of interest was current use of antihypertensive drugs, defined as drug dispensing within 90 days of the index date. / Statistical analysis. Relative risks were calculated with 95% confidence intervals using conditional logistic regression models. Full multivariate models, adjusting for all potential confounding covariates, were performed. / Results. Compared with diuretics, current use of calcium antagonists was associated with a 1.90-fold increase in risk of cardiovascular disease (RR 1.90; 95% Cl = 1.25--2.91). The current use of beta-blockers was not associated with an increase in morbidity. The risk of cardiovascular disease for angiotensin-converting enzyme inhibitors (ACE-I) relative to diuretics was found to be increased only in the subgroup of patients currently exposed to other antihypertensive drugs, including peripheral vasodilators, centrally-acting alpha 2 agonists, and a-blockers (RR 1.6; 95% Cl = 1.19--2.18). / Conclusion. Results of this research agree with the findings from several observational studies and clinical trials. However, factors influencing selective prescribing practices could not be completely accounted for and may partially explain our results.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33822 |
| Date | January 2002 |
| Creators | Pietrangelo, Maria G. |
| Contributors | Suissa, Samy (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001862422, proquestno: MQ78939, Theses scanned by UMI/ProQuest. |
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