Analysis of Treatment Patterns and Blood Pressure Changes According to Risk Stratification in Hypertensive Subjects.
- Author:
Dong Kie KIM
1
;
Dong Soo KIM
;
Tae Hyun YANG
;
Han Young JIN
;
Young Wan CHO
;
Young Kyeong SEO
;
Yong Bok KIM
;
Young Dae KIM
;
Taek Jong HONG
;
Sang Gon LEE
;
Tae Joon CHA
;
Tae Ik KIM
;
Byung Soo KIM
;
Dae Kyeong KIM
;
Doo Il KIM
Author Information
1. Inje University Busan Paik Hospital, Busan, Korea. dongskim@inje.ac.kr
- Publication Type:Original Article
- Keywords:
Antihypertensive agent;
Hypertension;
Practice pattern;
Risk factor
- MeSH:
Angiotensin Receptor Antagonists;
Angiotensin-Converting Enzyme Inhibitors;
Blood Pressure;
Humans;
Hypertension;
Retrospective Studies;
Risk Factors;
Tertiary Care Centers;
World Health;
World Health Organization
- From:Korean Journal of Medicine
2011;80(3):298-307
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The aims of this study were to identify real world treatment patterns of hypertension according to cardiovascular risk stratification and to evaluate blood pressure changes with anti-hypertensive treatment in each risk group. METHODS: This study included patients who were newly-diagnosed with hypertension or known hypertensive patients with uncontrolled blood pressure (BP) at seven tertiary hospitals in Busan and Ulsan. World Health Organization/International Society of Hypertension (WHO/ISH) cardiovascular risk stratification was performed through retrospective chart review. RESULTS: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were the most frequently prescribed drugs. The higher WHO/ISH risk group received a greater number of drugs at the initial treatment, and one year after treatment. Target BP was achieved less frequently in the higher risk group (68.2% vs. 85.2% vs. 89.0%, p < 0.001). The rate of attaining target BP was lower (50.7% vs. 81.6%, p < 0.001), and the time to attaining target BP was longer (106.5 +/- 79.2 days vs. 82.1 +/- 75.3, p = 0.001), in patients with renal disease or diabetes. Initial systolic BP above 160 mmHg (OR: 4.91, 95% CI: 2.27~10.65), renal disease (3.42, 1.60~7.32), medium or high risk group status (2.27, 1.23~4.20), initial diastolic BP above 100 mmHg (2.11, 1.11~4.04), and diabetes (2.06, 1.29~3.25) were independent factors that predicted failure of attaining the target BP. CONCLUSIONS: BP control was relatively unsatisfactory in patients with higher initial BP, renal disease, higher WHO/ISH risk group status, and diabetes. Individualized approaches for such patients are needed to improve BP control in routine clinical practice.
