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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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State general fund revenue estimates are generated by the Iowa Revenue Estimating Conference (REC). The REC is comprised of the Governor or their designee, the Director of the Legislative Services Agency, and a third person agreed upon by the other two members. The REC meets periodically, generally in October, December, and March/April. The Governor and the Legislature are required to use the REC estimates in preparing the state budget.

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BACKGROUND: Changes in antihypertensive drug treatment are paramount in the adequate management of patients with hypertension, still, there is little information regarding changes in antihypertensive drug treatment in Switzerland. Our aim was to assess those changes and associated factors in a population-based, prospective study. METHODS: Data from the population-based, CoLaus study, conducted among subjects initially aged 35-75 years and living in Lausanne, Switzerland. 772 hypertensive subjects (371 women) were followed for a median of 5.4 years. Data Subjects were defined as continuers (no change), switchers (one antihypertensive class replaced by another), combiners (one antihypertensive class added) and discontinuers (stopped treatment). The distribution and the factors associated with changes in antihypertensive drug treatment were assessed. RESULTS: During the study period, the prescription of diuretics decreased and of ARBs increased: at baseline, diuretics were taken by 46.9% of patients; angiotensin receptor blockers (ARB) by 44.7%, angiotensin converting enzyme inhibitors (ACEI) by 28.8%, beta-blockers (BB) by 28.0%, calcium channel blockers (CCB) by 18.9% and other antihypertensive drugs by 0.3%. At follow-up (approximately 5 years later), their corresponding percentages were 42.8%, 51.7%, 25.5%, 33.0% 20.7% and 1.0%. Among all participants, 54.4% (95% confidence interval: 50.8-58.0) were continuers, 26.9% (23.8-30.2) combiners, 12.7% (10.4-15.3) switchers and 6.0% (4.4-7.9) discontinuers. Combiners had higher systolic blood pressure values at baseline than the other groups (p < 0.05). Almost one third (30.6%) of switchers and 29.3% of combiners improved their blood pressure status at follow-up, versus 18.8% of continuers and 8.7% of discontinuers (p < 0.001). Conversely, almost one third (28.3%) of discontinuers became hypertensive (systolic ≥140 mm Hg or diastolic ≥90 mm Hg), vs. 22.1% of continuers, 16.3% of switchers and 11.5% of combiners (p < 0.001). Multivariate analysis showed baseline uncontrolled hypertension, ARBs, drug regimen (monotherapy/polytherapy) and overweight/obesity to be associated with changes in antihypertensive therapy. CONCLUSION: In Switzerland, ARBs have replaced diuretics as the most commonly prescribed antihypertensive drug. Uncontrolled hypertension, ARBs, drug regimen (monotherapy or polytherapy) and overweight/obesity are associated with changes in antihypertensive treatment.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.

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General fund receipts, monthly report for the State of Iowa, produced by the Department of Management.