Document Detail


Current status of antihypertensive prescription and associated blood pressure control in Japan.
MedLine Citation:
PMID:  16755149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The importance of tight blood pressure (BP) control has been established. We performed cross-sectional studies on the current status of BP control and the prescription and efficacy of antihypertensive drugs in hypertensive patients in Japan. The data were also evaluated in subgroups with or without diabetes mellitus (DM) and in winter and summer. Analyses were performed on the collected data of 12,437 treated hypertensive patients in winter and 5,972 in summer 2002. In winter, 50.3% of patients received calcium channel blockers (CCBs), 15.3% received angiotensin converting enzyme inhibitors (ACEIs) and 11.0% received angiotensin receptor blockers (ARBs). In the patients receiving monotherapy, 69% of patients received a CCB, 13% an ACEI and 11.0% an ARB. A total of 2,918 patients received combination therapy, and CCBs were the most frequently (89.6%) prescribed component of such therapy. Prescriptions of beta-blockers (BBs) decreased and those of CCBs and diuretics (D) increased with age (p<0.001). The rate of patients with adequately controlled BP less than 140/90 mmHg was 40.3% in the CCB group, 37.6% in the D group, and 36.9% in the BB group (p<0.001). In patients receiving combination therapy, those with CCB+D had the best rate of BP control (40.7%). The rate of patients with adequately controlled BP was lower in winter than in summer at both a target BP of 140/90 mmHg (36.2% vs. 43.8%, p<0.001) and a target BP of 130/85 mmHg in patients younger than 60 years old (15.5% vs. 18.6%, p<0.02). In diabetic patients, the target BP (130/80 mmHg) was achieved in only 11.3%, which was lower (p<0.05) than the rate in non-diabetic patients (13.1%). In conclusion, the present cross-sectional study showed that CCBs were the most frequently prescribed agent for the treatment of hypertension in Japan. The rate of adequate BP control was less than 50% and was even worse in patients with DM and in winter. Our results indicate that physicians should treat hypertension more intensively to achieve the target BP.
Authors:
Hisao Mori; Hiroshi Ukai; Hareaki Yamamoto; Saburo Saitou; Kouich Hirao; Mikio Yamauchi; Satoshi Umemura
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  29     ISSN:  0916-9636     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-06-06     Completed Date:  2006-07-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  143-51     Citation Subset:  IM    
Affiliation:
Japanese Medical and Dental Practitioners for the Improvement of Medical Care, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antihypertensive Agents / therapeutic use*
Blood Pressure / physiology
Breathing Exercises
Calcium Channel Blockers / therapeutic use
Cross-Sectional Studies
Diabetes Mellitus / physiopathology
Diuretics / therapeutic use
Drug Combinations
Female
Humans
Hypertension / drug therapy*,  physiopathology
Japan
Male
Middle Aged
Seasons
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Diuretics; 0/Drug Combinations

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