RESUMEN
STUDY OBJECTIVE: To develop and validate a predictive model for glucose change and risk for new-onset impaired fasting glucose in hypertensive participants following treatment with atenolol or hydrochlorothiazide (HCTZ). DESIGN: Randomized multicenter clinical trial. PATIENTS: A total of 735 white or African-American men and women with uncomplicated hypertension. MEASUREMENTS AND MAIN RESULTS: Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) is a randomized clinical trial to assess the genetic and nongenetic predictors of blood pressure response and adverse metabolic effects following treatment with atenolol or HCTZ. To develop and validate predictive models for glucose change, PEAR participants were randomly divided into a derivation cohort of 367 and a validation cohort of 368. Linear and logistic regression modeling were used to build models of drug-associated glucose change and impaired fasting glucose (IFG), respectively, in the derivation cohorts. These models were then evaluated in the validation cohorts. For glucose change after atenolol or HCTZ treatment, baseline glucose was a significant (p<0.0001) predictor, explaining 13% of the variability in glucose change after atenolol and 12% of the variability in glucose change after HCTZ. Baseline glucose was also the strongest and most consistent predictor (p<0.0001) for development of IFG after atenolol or HCTZ monotherapy. The area under the receiver operating curve was 0.77 for IFG after atenolol and 0.71 after HCTZ treatment, respectively. CONCLUSION: Baseline glucose is the primary predictor of atenolol or HCTZ-associated glucose increase and development of IFG after treatment with either drug.
Asunto(s)
Antagonistas de Receptores Adrenérgicos beta 1/efectos adversos , Atenolol/efectos adversos , Diuréticos/efectos adversos , Hidroclorotiazida/efectos adversos , Hiperglucemia/inducido químicamente , Hipertensión/tratamiento farmacológico , Modelos Biológicos , Antagonistas de Receptores Adrenérgicos beta 1/uso terapéutico , Adulto , Antihipertensivos/efectos adversos , Antihipertensivos/uso terapéutico , Atenolol/uso terapéutico , Glucemia/análisis , Estudios de Cohortes , Diuréticos/uso terapéutico , Quimioterapia Combinada/efectos adversos , Femenino , Intolerancia a la Glucosa/inducido químicamente , Intolerancia a la Glucosa/epidemiología , Humanos , Hidroclorotiazida/uso terapéutico , Hiperglucemia/epidemiología , Hipertensión/sangre , Masculino , Persona de Mediana Edad , Curva ROC , Riesgo , Estados Unidos/epidemiologíaAsunto(s)
Receptores Adrenérgicos beta 2/genética , Estudios de Asociación Genética , Humanos , Farmacocinética , Polimorfismo Genético/genética , Polimorfismo Genético/fisiología , Polimorfismo de Nucleótido Simple/genética , Polimorfismo de Nucleótido Simple/fisiología , Receptores Adrenérgicos beta 2/efectos de los fármacos , Receptores Adrenérgicos beta 2/fisiologíaRESUMEN
OBJECTIVES: To establish and assess the effectiveness of a 10-week summer research program on increasing doctor of pharmacy (PharmD) students' interest in research, particularly as it related to future career choices. DESIGN: Survey instruments were sent to 25 participants who had completed the research program in the summer of 2004, 2005, or 2006 to assess their satisfaction with the program and its influence on their career choices after graduation. ASSESSMENT: Respondents reported a high degree of satisfaction with the program, indicating that the program allowed them to determine their suitability for a career in research, and 55% reported their intention to pursue additional research training. CONCLUSION: A brief introduction to the clinical research environment helped pharmacy students understand the clinical sciences and careers in research. The introduction increased the likelihood of students pursuing a research career path after obtaining their PharmD degree.
