Document Detail


The therapeutic importance of home blood pressure assessment and combination antihypertensive therapy for achieving target blood pressure control: Ibaraki hypertension assessment trial.
MedLine Citation:
PMID:  20927115     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Tight blood pressure (BP) control is important for the prevention of cardiovascular disease in hypertensive patients. A cross-sectional study of 2339 patients from 101 clinics and hospitals in Ibaraki Prefecture was performed to evaluate BP control with the patients' current antihypertensive medication. Group A (n=892) included high-risk hypertensive patients with at least one of the following risk factors: diabetes mellitus, chronic kidney disease or a history of myocardial infarction. Group B (n=586) included patients <65 years old and Group C (n=859) included patients ≥65 years old. Both groups B and C included hypertensive patients without the above risk factors. A mean of 1.8±1.0 antihypertensive drugs per patient were prescribed. A total of 35.8% of all patients received monotherapy, 40% received a combination of three therapies and 20.3% received more than three kinds of drugs. The percentage of patients achieving the target BP at the office and at home was significantly higher in Group C than in the other groups (P<0.001). A combination of more than two antihypertensive drugs, including a high dose of either an angiotensin receptor blocker or a calcium channel blocker, was frequently prescribed to Group A to achieve the target office BP. Although the target BP should be lower in Group A (given their comorbidities), the absolute BP value and the number of medications were similar to the other groups. In conclusion, we demonstrated that physicians should treat hypertension more intensively with a combination of more than two antihypertensive drugs, using a high dose to achieve the target BP. In addition, it is important to teach hypertensive patients the clinical importance of monitoring their BP at home and the need to achieve home BP targets.
Authors:
Akira Sato; Shigeyuki Watanabe; Shinji Okubo; Toru Toi; Toshiki Doi; Hideaki Nakano; Junichi Tada; Kazutaka Aonuma;
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Publication Detail:
Type:  Journal Article     Date:  2010-10-07
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  33     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  1264-71     Citation Subset:  IM    
Affiliation:
Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan. asato@md.tsukuba.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Investigator
Investigator/Affiliation:
A Miyamoto / ; A Atsumi / ; A Katoh / ; A Imamura / ; A Yamazaki / ; A Goto / ; B Niho / ; D Abe / ; F Kamezaki / ; F Makabe / ; H Nakagawa / ; H Kobayashi / ; H Asakura / ; H Unno / ; H Kikuchi / ; H Nakajima / ; H Torigoe / ; H Tanaka / ; H Ebata / ; I Hanyuu / ; J Miyamoto / ; J Munakata / ; K Matsumaru / ; K Goshima / ; K Ishii / ; K Frushou / ; K Sugiura / ; K Narushima / ; K Taya / ; K Kawashima / ; M Kenmochi / ; M Yamaki / ; M Kaneko / ; M Endo / ; M Katou / ; M Komatsuzaki / ; M Sonobe / ; M Saitou / ; M Kanou / ; M Kobayashi / ; M Mizutani / ; M Ishii / ; M Ogura / ; M Kenjou / ; M Sasaki / ; M Noritake / ; M Itou / ; M Satoh / ; M Tokoi / ; M Miyazaki / ; M Hiyama / ; M Toyama / ; M Kuno / ; M Kumagae / ; N Maeda / ; N Murakoshi / ; N Yamaguchi / ; N Matsukura / ; N Takeyasu / ; R Yamada / ; R Tachieda / ; R Sugaya / ; R Kawakami / ; S Ebata / ; S Abeta / ; S Satou / ; S Watanabe / ; S Nemoto / ; S Suzuki / ; S Yamaguchi / ; S Gotou / ; T Morimoto / ; T Watanabe / ; T Kurosawa / ; T Saitou / ; T Ayabe / ; T Yodonawa / ; T Koh / ; T Kasano / ; T Ohkubo / ; T Ishizu / ; T Nagano / ; T Kaizan / ; T Kawamoto / ; T Inaba / ; T Murata / ; T Tasaki / ; T Aoki / ; T Enomoto / ; W Njaman / ; Y Ishii / ; Y Iwamoto / ; Y Shimizu / ; Y Takagi / ; Y Kusama / ; Y Seo / ; Y Obara / ; Y Itou / ; Y Handa / ; Y Shiraishi / ; Y Watanabe / ; Y Azami / ; Y Arita / ; Y Saitou / ; Y Shimizu / ; Y Watanabe / ; Y Hatagawa /

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