Mass clinical survey as a possible population strategy for the better control of hypertension in Japan

Tamura, Kouichi; Yamaji, Takahiro; Azushima, Kengo; Wakui, Hiromichi

doi:10.1038/s41440-019-0381-9

Cited by 1 publication

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One potential factor for the current situation, clinical inertia, where intensification of treatment is needed but not provided, has been reported. 29 It also has been reported that more antihypertensive prescriptions are accompanied by challenges such as poor adherence, 30 side effects, 31 and prescribing cascade that responds to the side effects of more medicine with further increases. 32 A medicine increase is known to cause problems with polypharmacy, especially when six or more drugs are prescribed, which can lead to increased side effects.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, approximately 90% of hypertensive patients aged < 75 years did not achieve the target level of home BP (< 125/75 mm Hg) set by JSH2019, regardless of the number of antihypertensives. One potential factor for the current situation, clinical inertia, where intensification of treatment is needed but not provided, has been reported 29 . It also has been reported that more antihypertensive prescriptions are accompanied by challenges such as poor adherence, 30 side effects, 31 and prescribing cascade that responds to the side effects of more medicine with further increases 32 .…”

Section: Discussionmentioning

confidence: 99%

“…One potential factor for the current situation, clinical inertia, where intensification of treatment is needed but not provided, has been reported. 29 It also has been reported that Abbreviations: BP, Blood pressure; HBP; Home blood pressure; HSBP, Home systolic blood pressure; OBP, Office blood pressure; OSBP, Office systolic blood pressure; SBP, Systolic blood pressure. a Resistant hypertension is defined as having an office blood pressure of 140/90 mm Hg or more while taking three antihypertensive medications, including diuretics, or taking four or more antihypertensive medications regardless of blood pressure level.…”

Section: Current Status Of Home Bp and Its Changes Over 20 Yearsmentioning

confidence: 99%

See 2 more Smart Citations

A Japan nationwide web‐based survey of estimation on patients for renal denervation based on blood pressure level and the number of antihypertensives (J‐NEEDs survey)

Kagitani

Hayashi

Hanamura

et al. 2021

J of Clinical Hypertension

View full text Add to dashboard Cite

Catheter‐based renal denervation (RDN) is currently being developed as a new complementary treatment option for hypertension. RDN has not yet received approval in Japan and so the number of possible candidates for RDN in Japan also remains unknown. A total of 10 756 hypertensive patients who regularly visit medical institutions and reported their latest home blood pressure (BP) values were identified from registrants at an online research company. They filled out a survey regarding their prescribed antihypertensives and latest BP values in March 2020 in Japan. The mean age of the patients was 61.3 years old (83.5% male). According to JSH 2019, the prevalence of resistant hypertension (RHT) was estimated to be 1.4% (0.52% having an office BP of 140/90 mm Hg or more while taking three antihypertensives, including diuretics; 0.84% taking four or more antihypertensives regardless of BP level). Assuming the indication for RDN was RHT with morning home systolic BP (HSBP) ≥ 135 mm Hg and office systolic BP (OSBP) ≥ 140 mm Hg, the number of candidates for RDN was estimated to be approximately 340 000 and 372 000, respectively. When hypertensive patients prescribed three or more, two, one, and no antihypertensives were included, the estimated number based on uncontrolled HSBP and OSBP cumulatively increased 2.6, 14.2, 40.6, and 58.0‐fold; 1.8, 8.6, 25.3, and 36.4‐fold, respectively. These findings revealed that a substantial number of hypertensive patients are unable to adequately control their BP level with existing treatments, and new complemental therapies, such as RDN, would alleviate the burden of hypertension in this population.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…One potential factor for the current situation, clinical inertia, where intensification of treatment is needed but not provided, has been reported. 29 It also has been reported that Abbreviations: BP, Blood pressure; HBP; Home blood pressure; HSBP, Home systolic blood pressure; OBP, Office blood pressure; OSBP, Office systolic blood pressure; SBP, Systolic blood pressure. a Resistant hypertension is defined as having an office blood pressure of 140/90 mm Hg or more while taking three antihypertensive medications, including diuretics, or taking four or more antihypertensive medications regardless of blood pressure level.…”

Section: Current Status Of Home Bp and Its Changes Over 20 Yearsmentioning

confidence: 99%

See 1 more Smart Citation