Analysis of antihypertensive drug use and ESRD incidence in Canada and US
Bibliographic record
Abstract
Antihypertensive drug use in North America has varied during the 1990s while the incidence rates of ESRD have increased. We analyzed variations in use of the four prominant drug categories retrospectively to determine if ESRD variation was associated with variations in antihypertensive drug use. Data fusion technique assessing market share of antihypertensive medications and annual changes in ESRD incidence was used. The predictor variables were market share percentage of total national cardiovascular expenditure for four medication groups (diuretics (D), beta-blockers (B), calcium channel blockers (C) or ACE-inhibitors (A)) in each country for the years 1990 to 2001 inclusive. Data were time-lagged by 4 years, consistent with our previous findings. Multiple regression analysis used MODSTAT (all rights reserved). Coefficients of correlation were calculated to show relationships between predictor variables and the dependent variable. Coefficients for each predictor variable are shown. Drugs associated with the highest predictor coefficient are associated with increased ESRD, and those with the lowest predictor coefficient have the lowest association. Drugs with a negative coefficient are protective, since increased use is associated with lower ESRD incidence. Canadian data show a coefficient of 0.95568, indicating that 91.33 percent of the variation in ESRD incidence in Canada from 1990-1996 could be explained by drug variations (p=0.037). From highest to lowest, the drugs had the following coefficients of prediction: diuretics (26.6), CCBs (3.3), ACE-Is (0.9), BB (−12.8). US data show a coefficient 0.91856, indicating that 84.37 percent of the variation in ESRD incidence in the US from 1990-1997 could be explained by drug variations (p=0.05). From highest to lowest, the drugs had the following coefficients of prediction: diuretics (6.7), CCBs (0.99), ACE inhibitors (−1.97), beta-blockers (−2.9). Retrospective analysis of antihypertensive medication use shows that variability of ESRD incidence is predicted knowing the market share of the major drug categories four years earlier. Diuretics were identified with the highest predictive coefficient associated with ESRD, CCBs were essentially neutral, ACE inhibitors (US) and beta-blockers (both) found a negative predictive coefficient, implying renoprotection. In both databases the order of coefficients for the drugs were D>C>A>B. Arguably JNC 7 and ALLHAT recommendations may need re-evaluation. Am J Hypertens (2004) 17, 22A–22A; doi: 10.1016/j.amjhyper.2004.03.051
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".