| アブストラクト | 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 <three antihypertensive drug classes for uncontrolled BP was 40.6%. Only 9.9% of patients with the pre-treatment BP >/= 180/ >/= 110 mmHg were prescribed >/= three antihypertensive drug classes. High pre-treatment BP and inadequate antihypertensive treatment were major factors contributing to uncontrolled BP. Adequate treatment intensification would resolve approximately 40% of uncontrolled BP cases among Japanese patients treated for hypertension. |
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| 投稿者 | Satoh, Michihiro; Muroya, Tomoko; Murakami, Takahisa; Obara, Taku; Asayama, Kei; Ohkubo, Takayoshi; Imai, Yutaka; Metoki, Hirohito |
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| 組織名 | 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.;Pharmaceutical University, Sendai, Japan.;Division of Internal Medicine, Izumi Hospital, Sendai, Japan.;Organization, Tohoku University, Sendai, Japan.;Division of Aging and Geriatric Dentistry, Department of Rehabilitation;Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.;Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan.;Department of Hygiene and Public Health, Teikyo University School of Medicine,;Tokyo, Japan.;Tohoku Institute for Management of Blood Pressure, Sendai, Japan. |
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