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

Lee, Sinjae

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-choice 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.