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Blood Pressure Control Rate and Changes in Medication Patterns after Antihypertensive Monotherapy Choice  

Lee, Sin-Jae (Nowon Health Center)
Publication Information
The Korean Journal of Medicine / v.80, no.2, 2011 , pp. 193-202 More about this Journal
Abstract
Background/Aims: This study was performed to observe blood pressure (BP) control rate with changes in patterns of antihypertensive drugs in patients with hypertension. Methods: The subjects were first prescribed antihypertensive drugs from 2001 to 2009 at [Nowon] health center. The study population consisted of 1588 subjects, and they were observed with 15 additional prescriptions through prospective cohort methods. Patient initial systolic blood pressures (SBP) were >140 mmHg in all cases. Results: BP was controlled in 31.3% of subjects through the first prescribed antihypertensive drugs. Calcium channel blockers (CCB) were the most common first-ichoice medications (52.3%), which lowered BP by 12.9 mmHg at the first prescription. The most common converted drugs in monotherapy were CCB, and CCB were converted to angiotensin II type 1 receptor blockers (ARB). Dichlozide (DCZ) was the most common medication added to CCB. The combination patterns involved addition of DCZ, CCB, and beta blockers (BB). The most common combination pattern was DCZ+CCB, and CCB (72.9%) showed the strongest BP control rate at the endpoint. Among the combination therapies, BB+DCZ+CCB (69.2%) showed the strongest BP control rate at the endpoint. Conclusions: The control rate was increased with additional visits but reached a plateau (69.8%) after the 14th visit. The percentages of monotherapy and combinations were 53.3% and 46.7%, respectively. To increase the overall control rate, further studies are needed to evaluate uncontrolled hypertension from the viewpoint of resistant hypertension.
Keywords
Control rate; Monotherapy; Combination therapy;
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1 Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Selected major risk factors and global and regional burden of disease. Lancet 2002;360:1347-1360.   DOI   ScienceOn
2 Cherry DK, Woodwell DA. National Ambulatory Medical Care Survey: 2000 summary. Adv Data 2002;328:1-32.
3 World Health Organization. Preventing chronic disease: a vital investment. Geneva, World Health Organization, 2005.
4 Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326:1419.   DOI   ScienceOn
5 Jee SH, Suh I, Kim IS, Appel LJ. Smoking and atherosclerotic cardiovascular disease in men with low levels of serum cholesterol: the Korea medical insurance corporation study. JAMA 1999;282:219-2155.   DOI   ScienceOn
6 Borzecki AM, Oliveria SA, Berlowitz DR. Barriers to hypertension control. Am Heart J 2005;149:785-794.   DOI   ScienceOn
7 Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? Eff Clin Pract 1998;1:2-4.
8 Steinman MA, Fischer MA, Shlipak MG, et al. Clinician awareness of adherence to hypertension guidelines. Am J Med 2004;117:747-754.   DOI   ScienceOn
9 Kim SY, Cho IS, Lee JH, et al. Physician factors associated with the blood pressure control among hypertensive Patients. J Prev Med Public Health 2007;40:487-494.   DOI   ScienceOn
10 Kim KI, Kim Y, Kim HJ, et al. Current status and characteristics of hypertension treatment by primary physicians in Korea: data from Korean epidemiology study on hypertension (KEY study). Am J Hypertens 2008;21:884-889.   DOI   ScienceOn
11 UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in Type 2 diabetes : UKPDS 38. BMJ 1998;317:703-713.   DOI   ScienceOn
12 Jeffrey S. New JNC 7 hypertension guidelines released 2003. Available from: http://www.theheart.org/article/.
13 Lee TY, Reconsideration of hypertension awareness, treatment, and control. Korean Hypertension J 2009;15:1-6.
14 Taler SJ, Textor SC, Augustine JE. Resistant hypertension: comparing hemodynamic management to specialist care. Hypertension 2002;39:982-988.   DOI   ScienceOn
15 Hirsch S. A different approach to resistant hypertension. Clev Clin J Med 2007;74:449-456.   DOI   ScienceOn
16 Hansson L, Zanchetti A, Carruthers SG, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomized trial. Lancet 1998;351:1755-1762.   DOI   ScienceOn
17 Winker MA, Murphy MB. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final result of the systolic hypertension in elderly program (SHEP). JAMA 1991;265:3255-3264.   DOI   ScienceOn
18 Park GS, Ra HJ, Joe HG, et al. Pattern of hypertensive management and usefulness of treatment guideline in primary care. J Korean Acad Fam Med 2006;27:789-797.
19 Ostchega Y, Yoon SS, Hughes J, Louis T. Hypertension awareness, treatment, and control - continued disparities in adults: United States, 2005-2006. NCHS Data Brief 2008:1-8.
20 질병관리본부. 2008년 국민건강통계-국민건강영양조사 제4기 2차년도 조사결과 보고서. 2009.
21 Mancia G, De Backer G, Dominiczak A, et al. 2007 guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the european society of hypertension (ESH) and the European society of cardiology (ESC). J Hypertens 2007;25:1105-1187.   DOI   ScienceOn