| Autor: |
Satoh M; Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan. satoh.mchr@tohoku-mpu.ac.jp.; Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan. satoh.mchr@tohoku-mpu.ac.jp.; Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan. satoh.mchr@tohoku-mpu.ac.jp., Muroya T; Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.; Division of Internal Medicine, Izumi Hospital, Sendai, Japan., Murakami T; Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.; Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.; Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan., Obara T; Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.; Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan., Asayama K; Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.; Tohoku Institute for Management of Blood Pressure, Sendai, Japan., Ohkubo T; Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.; Tohoku Institute for Management of Blood Pressure, Sendai, Japan., Imai Y; Tohoku Institute for Management of Blood Pressure, Sendai, Japan., Metoki H; Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.; Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.; Tohoku Institute for Management of Blood Pressure, Sendai, Japan. |
| Abstrakt: |
We aimed to quantify the impact of inadequate pharmacological therapy on uncontrolled blood pressure (BP) using Japanese real-world data. This retrospective cohort study used databases provided by DeSC Healthcare, Inc (Tokyo, Japan). We identified 27,652 patients with hypertension (age, 60.7 ± 9.1 years; men, 56.4%) who were not receiving antihypertensive treatment at the initial visit (pre-treatment) and were under treatment at the next visit (post-treatment). Patients were classified into the following groups by the number of antihypertensive drug classes and defined daily dose (DDD): one antihypertensive drug class with a low dose (DDD < 1.0), one antihypertensive drug class with a moderate-to-high dose (DDD ≥ 1.0), two antihypertensive drug classes with a low dose (DDD < 2.0), two antihypertensive drug classes with a moderate-to-high dose (DDD ≥ 2.0), and ≥three antihypertensive drug classes. The pre-treatment systolic/diastolic BP was 157.7 ± 15.4/94.2 ± 11.5 mmHg. Overall, 43.0% of patients had uncontrolled BP (post-treatment BP ≥ 140/ ≥ 90 mmHg). High pre-treatment BP was a strong factor for uncontrolled BP. After adjustments for covariates, including the pre-treatment mean BP, the proportion of patients with uncontrolled BP was 2.08 times higher in the one antihypertensive drug class with a low dose group than in the ≥three antihypertensive drug classes group. The preventable fraction due to (© 2023. The Author(s), under exclusive licence to The Japanese Society of Hypertension.) |
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