Antihypertensive Prescriptions Over a 10-Year Period in a Large Chinese Population

BACKGROUND International guidelines recommending antihypertensive prescriptions for the management of hypertension have been published in the past decade. Beta-blocker use was discouraged by a significant body of evidence and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor b...

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Bibliographic Details
Published in:American journal of hypertension 2013-07, Vol.26 (7), p.931-938
Main Authors: Wong, Martin C.S., Tam, Wilson W.S., Cheung, Clement S.K., Tong, Ellen L.H., Sek, Antonio C.H., Cheung, N.T., Yan, Bryan P.Y., Yu, Cheuk-Man, Griffiths, Sian M.
Format: Article
Language:English
Subjects:
Adult
Aged
Antihypertensive Agents - therapeutic use
Diuretics
Drug Prescriptions - statistics & numerical data
Drug therapy
Female
Hong Kong - epidemiology
Humans
Hypertension - drug therapy
Hypertension - epidemiology
Male
Middle Aged
Morbidity - trends
Prescriptions
Registries
Retrospective Studies
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Summary:BACKGROUND International guidelines recommending antihypertensive prescriptions for the management of hypertension have been published in the past decade. Beta-blocker use was discouraged by a significant body of evidence and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) were found more effective among younger patients. This study aims to evaluate the trends in prescription profiles in a large Chinese population because patterns of antihypertensive agent dispensation represent important information for physicians and policymakers. METHODS From clinical databases consisting of all patient records in the public health-care system of Hong Kong, we examined all antihypertensive prescriptions according to the drug classes (thiazide diuretics, alpha-blockers, beta-blockers, calcium channel blockers (CCBs), ACEIs, ARBs, fixed-dose combinations, and polytherapy (2, ≥3)) between 2001 and 2010. We retrieved >6.3 million prescription episodes for 223,287 patients. RESULTS The average age of the patients was 59.9 years (SD = 17.6), and 54.8% were women. According to prescription episodes, the most commonly prescribed medications were beta-blockers (31.7%) and CCBs (29.2%), followed by ACEIs (13.9%), thiazide diuretics (5.0%), and alpha-blockers (4.5%). Between 2001 and 2010, the prescription proportions of beta-blockers decreased from 41.5% to 21.5%, whereas that of ARBs increased from 0.5% to 1.0% (P < 0.001, χ2 test for trend). It was found that the decline of beta-blockers (71.0% to 35.4%) and increase in ARB prescriptions (0.4% to 1.0%) were particularly marked among younger subjects aged
ISSN:0895-7061
1941-7225
DOI:10.1093/ajh/hpt049