INTRODUCTION:Calcium channel blockers (CCBs), such as nifedipine, are commonly used to treat hypertensive disorders of pregnancy (HDP). With the withdrawal of Nifedipine-RETARD and the limitations in compounding formulations, the off-label use of amlodipine (AML) has increased. The primary objective of this study was to describe the frequency of AML use, while the secondary objective was to outline the professional profile of the surveyed physicians. MATERIALS AND METHODS:A descriptive, observational, cross-sectional study conducted in 2024 using closed digital surveys. The target population included physicians of both sexes involved in the care of HDP in Argentina, with access to electronic devices and the Internet. The survey was developed by the Working Group on Hypertension in Women of the Argentine Society of Hypertension (SAHA) and validated by experts. It was distributed through social networks and SAHA's email list. RESULTS:A total of 276 physicians were surveyed, with a mean age of 49.6±11.5 years, 46.6% of whom were women. Among the respondents, 213 (77.1%) used CCBs to treat HDP, and 176 (63.8%) reported prescribing AML. Of those prescribing AML, 51% were general practitioners, 12% cardiologists, 22% obstetrician-gynaecologists, and 14% belonged to other specialties. The initial dose reported was 5mg/day in 82.4% of cases. The main reasons cited for not prescribing AML were lack of experience (44.4%) and perceived insufficient scientific evidence (28.9%). CONCLUSIONS:The use of AML was frequent, with 6 out of 10 surveyed physicians reporting its use.
INTRODUCTION:The relationship between the American Heart Association's (AHA) new Predicting Risk of cardiovascular disease EVENTs (PREVENT) risk and long-term disease progression, like mortality, is unresolved. We investigated the associations of PREVENT cardiovascular disease (CVD) risk with all-cause, CVD, and non-CVD mortality among adults in the US. METHODS:This cohort study used data from 30,544 adults from 2003-2018 survey cycles of the National Health and Nutrition Examination Survey and linked to the mortality data until 2019. All-cause mortality, further stratified into CVD and non-CVD mortality, were defined by the leading cause of death using the International Classification of Diseases codes. Employing PREVENT's base model and component variables, we estimated 10-year total CVD risk stratified into low (<5%), borderline (5-7.4%), intermediate (7.5-19.9%), and high (≥20%). Multivariable Cox proportional hazards regression (hazard ratio [HR] and 95% confidence interval [CI]) analyses were used. RESULTS:Participants' mean±SD age was 50.3±13.1 years, with a balanced sex distribution. Compared to individuals with low CVD risk, those with borderline and intermediate risks had a greater risk of all-cause mortality (HR [95% CI], 1.08 [1.03-1.13] and 1.12 [1.08-1.16], respectively). Those with borderline, intermediate, and high risks had a greater risk of CVD mortality (HR [95% CI], 1.11 [1.06-1.16], 1.21 [1.18-1.25], and 1.40 [1.33-1.47], respectively), compared to low-risk individuals. Similar trends were observed for non-CVD mortality. With significant racial/ethnic group-interactions, the associations were evident in Mexican Americans. CONCLUSIONS:Higher PREVENT 10-year CVD risk is associated with higher risk of all-cause, CVD, and non-CVD mortality, and the associations differ by race/ethnicity.
