Antihypertensive prescription patterns and cardiovascular risk in patients with newly diagnosed hypertension- an analysis of statutory health insurance data in Germany

Beger, Christian; Unger, Thomas; Haller, Hermann; Limbourg, Florian P.

doi:10.1080/08037051.2020.1779582

Cited by 11 publications

(8 citation statements)

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“…However, our study observed that majority of subjects accounting for around 78% of general patients currently used monotherapy and the mean number of antihypertensive drugs prescribed in the present study was 1.88 ± 1.11. The prescription rate of one drug therapy was comparable to the finding of an earlier nationwide hypertension survey which reported about 70% of treated hypertensive patients used one drug for individuals with hypertension [ 27 ] but significantly higher than that of foreign countries with the prescription rate of monotherapy as 53.1% in Malaysia [ 28 ] and 55.4% in Germany [ 29 ]. According to JNC 8 guideline [ 8 ], patients with hypertension were recommended to receive combination therapy from the first prescription.…”

Section: Discussionsupporting

confidence: 74%

Analysis of prescription status of antihypertensive drugs in Chinese patients with hypertension based on real-world study

et al. 2023

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Background Globally, the prevalence of hypertension and the accompanying burden of cardiovascular disease are increasing. Through drug utilization research, we can understand the prescription status of hypertension patients and promote rational drug use. The purpose of this retrospective study was to describe the current prescription pattern of antihypertensive drugs in Chinese patients and determine the compliance level of treatment guidelines. Materials and methods Around 11.1 million patients who received a prescription for antihypertensive therapy between January 2021 to December 2021 were obtained from a database of Hangzhou Kang Sheng Health Consulting CO., Ltd. Results The mean age of hypertensive patients was 54.75 ± 12.98 years. About 6.7 million (60.30%) were males. About 46.07% of patients had comorbidities. The most common classes of antihypertensive medications used were calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs). Around 78.33% of participants were on monotherapy. Diuretics + ARBs and Diuretics + CCBs + ARBs were the most commonly prescribed pattern in two-drug combination therapy and three-drug combination therapy, respectively. Conclusions CCBs and ARBs were the two most frequently prescribed for patients with hypertension. The prescription pattern of antihypertensive medications in the study largely complied with recommended Chinese hypertension guidelines. Key messages Cardiovascular disease is the most common complication of hypertension. Calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs) are the two most commonly used drugs for hypertension patients in China. The proportion of combination prescription pattern in Chinese hypertensive patients is low.

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Section: Discussionsupporting

confidence: 74%

Analysis of prescription status of antihypertensive drugs in Chinese patients with hypertension based on real-world study

et al. 2023

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“…19 In practice, ACE inhibitors and β-blockers are most commonly prescribed as first-line therapy in Germany, followed by ARBs, CCBs, and diuretics. 31 Third, priori-tized prescription of ARBs for low-grade hypertension, which could represent a potential bias in our study, is not recommended by the guidelines and does not correspond with prescribing behavior in Germany. Fourth, the post hoc analysis (Table 3) does not indicate that patients with mild hypertension in the sample received ARBs in particular, making such a bias unlikely.…”

Section: Limitationsmentioning

confidence: 79%

Association Between Angiotensin Receptor Blocker Therapy and Incidence of Epilepsy in Patients With Hypertension

Doege¹,

Luedde

Kostev³

2022

JAMA Neurol

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ImportanceArterial hypertension is associated with an increased incidence of epilepsy. Results from animal studies suggest that angiotensin receptor blocker (ARB) therapy could inhibit epileptic seizures. However, there is a lack of clinical data to support the use of ARB therapy in humans.ObjectiveTo assess whether ARB therapy is associated with a decreased incidence of epilepsy in patients with hypertension.Design, Setting, and ParticipantsThis cohort study obtained data from the Disease Analyzer database (IQVIA) on patients aged 18 years or older who had hypertension and at least 1 antihypertensive drug prescription. Patients were treated at 1274 general practices between January 2010 and December 2020 in Germany. Data were available for 1 553 875 patients who had been prescribed at least 1 antihypertensive drug. Patients diagnosed with epilepsy before or up to 3 months after the index date were excluded. A total of 168 612 patients were included in propensity score matching. Patients treated with 1 of 4 antihypertensive drug classes (β-blockers, ARBs, angiotensin-converting enzyme inhibitors, and calcium channel blockers [CCBs]) were matched to each other using propensity scores.Main Outcomes and MeasuresThe main outcome of the study was the incidence of epilepsy associated with ARB therapy compared with other antihypertensive drug classes. Cox regression models were used to study the association between the incidence of epilepsy and ARBs compared with all other antihypertensive drug classes as a group.ResultsThe study included a total of 168 612 patients, with 42 153 in each antihypertensive drug class. The mean [SD] age of patients was 62.3 [13.5] years, and 21 667 (51.4%) were women. The incidence of epilepsy within 5 years was lowest among patients treated with ARBs (0.27% at 1 year, 0.63% at 3 years, 0.99% at 5 years) and highest among patients receiving β-blockers and CCBs (0.38% for both β-blockers and CCBs at 1 year; 0.91% for β-blockers and 0.93% for CCBs at 3 years; β-blockers, 1.47%; and CCBs, 1.48% at 5 years). Angiotensin receptor blocker therapy was associated with a significantly decreased incidence of epilepsy (hazard ratio, 0.77; 95% CI, 0.65-0.90) compared with the other drug classes as a group.Conclusions and RelevanceIn this cohort study of patients with hypertension, ARB therapy was associated with a significantly decreased incidence of epilepsy. The findings suggest antihypertensive drugs could be used as a novel approach for preventing epilepsy in patients with arterial hypertension.

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“…Cardiovascular diseases have emerged as the leading cause of death globally [ 1 ]; they were responsible for 17.8 million deaths in 2017 [ 2 ]. Hypertension, one of many biomedical risk factors from cardiovascular disease, causes more deaths than any other single factor [ 3 ]. A total of 1.38 billion people worldwide are estimated to have hypertension without optimal control [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of chronic disease management mode (CDMM) on participants with primary hypertension

Ling

Chen

et al. 2021

Tropical Med Int Health

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objective Hypertension requires continuous and long-term care to prevent associated complications. Chronic disease management mode (CDMM) was developed to improve patients' selfmanagement. We aimed to evaluate quality of care and clinical outcomes of CDMM versus routine care.methods 300 patients aged >30 years with primary hypertension were randomly allocated to the CDMM intervention group (n = 162) or the usual care control group (n = 138). CDMM comprised nursing consultations, telephone contact, online WeChat link, health education, and appropriate referrals during hospitalisation and after discharge. QLICD-HY (V 2.0) scale was used to evaluate the quality of life. Care outcomes were biochemical parameters, body mass index, blood pressure levels, waist circumference, psychological indicators and quality of life assessed on admission (baseline) and one month post-care for both groups. Data were collected and analysed using SPSS 20.0.results After one month, the intervention group had 6 mm Hg (95% CI: −5.12 to −9.08) lower SBP and 0.6 mM/L (95% CI: −0.52 to −0.68) lower LDL than the control group. In terms of improvements in BMI, UmAlb or waist circumference, there were no differences between both groups. The intervention group scored better on psychological indicators than controls (P < 0.05), and scores reflecting social and psychological function in the intervention group were significantly higher than scores at baseline, and higher than scores of controls after one month (P < 0.05). In the control group, there was no statistically significant difference between the scores at baseline and after one month.conclusions Under CDMM hypertension care, improvement of blood pressure and LDL was clinically significant. Intervention care further improves social and psychological function among participants with primary hypertension. keywords chronic disease management mode, systolic blood pressure, QLICD-HY, primary hypertension, nurse Sustainable Development Goals: Good health and well-beingThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Antihypertensive prescription patterns and cardiovascular risk in patients with newly diagnosed hypertension- an analysis of statutory health insurance data in Germany

Cited by 11 publications

References 11 publications

Analysis of prescription status of antihypertensive drugs in Chinese patients with hypertension based on real-world study

Analysis of prescription status of antihypertensive drugs in Chinese patients with hypertension based on real-world study

Association Between Angiotensin Receptor Blocker Therapy and Incidence of Epilepsy in Patients With Hypertension

Assessment of chronic disease management mode (CDMM) on participants with primary hypertension

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