Analysis of antihypertensive treatment using real-world Japanese data—the retrospective study of antihypertensives for lowering blood pressure (REAL) study

Hypertension requires strict treatment because it causes diseases that can lead to death. Although various classes of antihypertensive drugs are available, the actual status of antihypertensive drug selection and the transition in prescription patterns over time have not been fully examined. Therefo...

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Vydáno v:Hypertension research Ročník 42; číslo 7; s. 1057 - 1067
Hlavní autoři: Ohishi, Mitsuru, Yoshida, Takuo, Oh, Akinori, Hiroi, Shinzo, Takeshima, Tomomi, Otsuka, Yujiro, Iwasaki, Kosuke, Shimasaki, Yukio
Médium: Journal Article
Jazyk:angličtina
Vydáno: England Nature Publishing Group 01.07.2019
Springer Singapore
Témata:
Adrenergic beta-Antagonists - pharmacology
Adrenergic beta-Antagonists - therapeutic use
Adult
Age Factors
Aged
Aged, 80 and over
Angiotensin Receptor Antagonists - pharmacology
Angiotensin Receptor Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - pharmacology
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Antihypertensive Agents - pharmacology
Antihypertensive Agents - therapeutic use
Antihypertensives
Blood Pressure - drug effects
Calcium Channel Blockers - pharmacology
Calcium Channel Blockers - therapeutic use
Databases, Factual
Diuretics
Female
Humans
Hypertension
Hypertension - drug therapy
Japan
Male
Middle Aged
Prescription drugs
Retrospective Studies
Treatment Outcome
Japan
Diuretics
Calcium channel blockers
Antihypertensive agents
Real-world data
Angiotensin II receptor antagonists
ISSN:0916-9636, 1348-4214, 1348-4214
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Shrnutí:Hypertension requires strict treatment because it causes diseases that can lead to death. Although various classes of antihypertensive drugs are available, the actual status of antihypertensive drug selection and the transition in prescription patterns over time have not been fully examined. Therefore, we conducted a claims-based study using two claims databases (2008–16) to determine this status in Japan. We examined the prescription rate for each class of antihypertensive drugs in hypertensive patients and compared the patients’ ages and the sizes of the medical institutions treating these patients. Among the 1 560 865 and 302 433 hypertensive patients in each database, calcium channel blockers (CCBs) (>60%) and angiotensin II receptor blockers (ARBs) (>55%) were the most frequently prescribed classes. The prescription rate of CCBs increased and ARBs decreased with the patients’ ages. Although the Japanese guidelines for management of hypertension in 2014 changed the recommendation and indicated that β-blockers should not be used as first-line drugs, their prescription status did not change during this study period up to 2016. Use of CCBs and ARBs as first-line drugs differed by the types of patient comorbidities. Although ARBs or angiotensin-converting enzyme inhibitors were recommended for patients with some comorbidities, CCBs were used relatively frequently. In conclusion, the patients’ ages and comorbidities and the sizes of the medical institutions affect the selection of antihypertensive drugs. Selection and use of drugs may not always follow the guidelines.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0916-9636
1348-4214
1348-4214
DOI:10.1038/s41440-019-0238-2