Current prescription status of antihypertensive drugs with special reference to the use of diuretics in Japan

Ibaraki, Ai; Goto, Wataru; Iura, Rie; Tominaga, Mitsuhiro; Tsuchihashi, Takuya

doi:10.1038/hr.2016.120

Cited by 17 publications

(31 citation statements)

References 15 publications

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“…The present analyses show that the real‐world use of FDC varies depending on the desired combination and number of agents prescribed. Overall, the majority of patients in the present study were prescribed one or two antihypertensive agents, and the most frequently prescribed classes of agents were CCB and ARB, consistent with similar analyses carried out in Japan using pharmacy prescription data . We found that the prescription rate of CCB + ARB FDC was relatively low overall, and did not increase depending on the total number of antihypertensive agents prescribed.…”

Section: Discussioncontrasting

confidence: 99%

“…15 In the same study, the prescription rate of a CCB + an ARB FDC was also higher than we found in the present study, although the frequencies of an ARB + a diuretic prescriptions were similar. 15 This is might be due to differences in sampling of the databases (local non-acute hospitals vs national acute hospitals). Although some differences in comorbidities were noted among patients who were prescribed an ARB AE a diuretic FDC or multi-pill combination, small sample sizes in these subgroups prevented meaningful comparisons, and further investigation of these findings is required.…”

Section: Discussionsupporting

confidence: 67%

“…Overall, the majority of patients in the present study were prescribed one or two antihypertensive agents, and the most frequently prescribed classes of agents were CCB and ARB, 12 consistent with similar analyses carried out in Japan using pharmacy prescription data. 15 We found that the prescription rate of CCB + ARB FDC was relatively low overall, and did not increase depending on the total number of antihypertensive agents prescribed. In contrast, the prescription rate of ARB + diuretic FDC increased as the number of concomitant antihypertensive agents used increased.…”

Section: Discussionmentioning

confidence: 68%

“…In contrast, the prescription rate of ARB + diuretic FDC increased as the number of concomitant antihypertensive agents used increased. This is in contrast to the pharmacy prescription data study in which the proportions increased for both FDC . In the same study, the prescription rate of a CCB + an ARB FDC was also higher than we found in the present study, although the frequencies of an ARB + a diuretic prescriptions were similar .…”

Section: Discussionmentioning

confidence: 99%

“…This is in contrast to the pharmacy prescription data study in which the proportions increased for both FDC . In the same study, the prescription rate of a CCB + an ARB FDC was also higher than we found in the present study, although the frequencies of an ARB + a diuretic prescriptions were similar . This is might be due to differences in sampling of the databases (local non‐acute hospitals vs national acute hospitals).…”

Section: Discussionmentioning

confidence: 99%

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Treatment patterns of antihypertensive fixed‐dose combinations according to age and number of agents prescribed: Retrospective analysis using a Japanese claims database

Ishida

Nishigaki

et al. 2019

Geriatrics Gerontology Int

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Aim To determine the real‐world use of fixed‐dose combinations (FDC) of antihypertensive agents using data collected from a nationwide medical database of acute hospitals in Japan. Methods We carried out a retrospective analysis of data from the Medical Data Vision database for patients with hypertension who received an antihypertensive drug prescription between April 2014 and March 2015. The prescription rate of antihypertensive FDC were assessed by class, age and according to combinations. Results In total, data from 59 867 patients aged 70.0 ± 11.9 years (mean ± SD) were analyzed. Patients were prescribed 1.9 ± 1.0 oral antihypertensive agents (mean ± SD). Overall, 58.6% of patients were prescribed two or more antihypertensive agents, and the most frequently prescribed classes were calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB). As the number of concomitant antihypertensive agents prescribed increased, the prescription rate of a CCB + an ARB FDC decreased, whereas the prescription rate of an ARB + a diuretic FDC increased. This trend was the same regardless of age. Of the 12 222 patients who were prescribed a CCB + an ARB, 26.0% received a FDC. In contrast, of the 922 patients prescribed an ARB + a thiazide diuretic, 80.6% received a FDC. Medium doses of both CCB and ARB agents, and low doses of diuretics were the most frequently prescribed for each class. Conclusions Our analyses show that the real‐world use of FDC varies depending on the combination of agent class and the number of prescriptions; the latter was similar regardless of age. Geriatr Gerontol Int 2019; 19: 1077–1083.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Treatment patterns of antihypertensive fixed‐dose combinations according to age and number of agents prescribed: Retrospective analysis using a Japanese claims database

Ishida

Nishigaki

et al. 2019

Geriatrics Gerontology Int

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Antihypertensive Effect of Long-Term Monotherapy with Esaxerenone in Patients with Essential Hypertension: Relationship Between Baseline Urinary Sodium Excretion and Its Antihypertensive Effect

Ichikawa¹,

Tsutsumi

Sugimoto

et al. 2022

Adv Ther

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Introduction:The blood pressure (BP) control mechanism for mineralocorticoid receptor blockers is unclear, and analysis of their use as a single agent in the clinical setting is required to resolve this uncertainty. There is a paucity of data on esaxerenone monotherapy assessing its long-term antihypertensive effect and urinary biomarkers. Methods: This post hoc exploratory substudy of a long-term phase 3 study evaluated the effect of esaxerenone monotherapy (2.5 or 5 mg/day) in treatment-naı ¨ve patients who continued the therapy during the 52-week study period (n = 25). In addition to blood biomarkers, urinary biomarkers were also assessed in 24-h urine collection samples. Results: Esaxerenone monotherapy was associated with consistent reductions in systolic/diastolic BP in the substudy population (-23.5/-13.1 mmHg at week 52, p \ 0.001 vs baseline). Plasma aldosterone concentrations and plasma renin activity significantly increased during esaxerenone monotherapy at all time points. On the basis of the observations that both urine volume and urinary sodium excretion also decreased up to the end of the study, and were significantly lower at 12 weeks, patients were further categorized into higher/ lower urinary sodium excretion subgroups according to whether their baseline values were above or below the median. In the group with higher baseline urinary sodium excretion, esaxerenone exhibited a significantly greater decrease in systolic/diastolic BP compared to the lower baseline group. Conclusion: Esaxerenone exhibited sustained and stable antihypertensive activity even when administered as a single agent for 52 weeks in patients with essential hypertension. The additional urinary biomarker analysis suggests that the BP-lowering effects of esaxerenone may be partly exerted via mechanisms related to salt and water retention, and that the effect is particularly pronounced in patients with hypertension and higher baseline urinary sodium excretion, which may reflect a state of excessive salt intake. Trial registration: NCT02722265.

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Management of Hypertension in the Asia-Pacific Region: A Structured Review

Rahman,

Magno,

Cai

et al. 2024

Am J Cardiovasc Drugs

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This article reviews available evidence regarding hypertension management in the Asia-Pacific region, focussing on five research questions that deal with specific aspects: blood pressure (BP) control, guideline recommendations, role of renin–angiotensin–aldosterone system (RAAS) inhibitors in clinical practice, pharmacological management and real-world adherence to guideline recommendations. A PubMed search identified 2537 articles, of which 94 were considered relevant. Compared with Europeans, Asians have higher systolic/diastolic/mean arterial BP, with a stronger association between BP and stroke. Calcium channel blockers are the most-commonly prescribed monotherapy in Asia, with significant variability between countries in the rates of angiotensin-converting enzyme inhibitors (ACEis)/angiotensin-receptor blockers (ARBs) and single-pill combination (SPC) use. In clinical practice, ARBs are used more commonly than ACEis, despite the absence of recommendation from guidelines and clinical evidence supporting the use of one class of drug over the other. Ideally, antihypertensive treatment should be tailored to the individual patient, but currently there are limited data on the characteristics of hypertension in Asia-Pacific individuals. Large outcome studies assessing RAAS inhibitor efficacy and safety in multi-national Asian populations are lacking. Among treated patients, BP control rates were ~ 35 to 40%; BP control in Asia-Pacific is suboptimal, and disproportionately so compared with Western nations. Strategies to improve the management of hypertension include wider access/availability of affordable treatments, particularly SPCs (which improve adherence), effective public health screening programs targeting patients to drive health-seeking behaviours, an increase in physician/patient awareness and early implementation of lifestyle changes. A unified Asia-Pacific guideline on hypertension management with pragmatic recommendations, particularly in resource-limited settings, is essential. Supplementary Information The online version contains supplementary material available at 10.1007/s40256-023-00625-1.

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Current prescription status of antihypertensive drugs with special reference to the use of diuretics in Japan

Cited by 17 publications

References 15 publications

Treatment patterns of antihypertensive fixed‐dose combinations according to age and number of agents prescribed: Retrospective analysis using a Japanese claims database

Treatment patterns of antihypertensive fixed‐dose combinations according to age and number of agents prescribed: Retrospective analysis using a Japanese claims database

Antihypertensive Effect of Long-Term Monotherapy with Esaxerenone in Patients with Essential Hypertension: Relationship Between Baseline Urinary Sodium Excretion and Its Antihypertensive Effect

Management of Hypertension in the Asia-Pacific Region: A Structured Review

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