Improvement of Blood Pressure Control in a Hypertension Clinic in Japan: A 15-Year Follow-Up Study

• Published in: Clinical and experimental hypertension (1993) 2009-11, Vol.31 (7), p.553-559
• Main Authors: Ohta, Yuko, Matsumura, Kiyoshi, Tsuchihashi, Takuya, Ohtsubo, Toshio, Arima, Hisatomi, Miwa, Yoshikazu, Goto, Kenichi, Ohya, Yusuke, Fujii, Koji, Uezono, Keiko, Abe, Isao, Iida, Mitsuo
• Format: Article
• Language: English
• Subjects: Adrenergic alpha-Antagonists - therapeutic use; Adrenergic beta-Antagonists - therapeutic use; Aged; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; anti-hypertensive drugs; Antihypertensive Agents - therapeutic use; Blood Pressure - drug effects; BP control; diuretics; Diuretics - therapeutic use; follow-up patients; Follow-Up Studies; Humans; Hypertension - blood; Hypertension - drug therapy; Hypertension - physiopathology; Japan; Male; Middle Aged; Outpatient Clinics, Hospital; Practice Guidelines as Topic; Renin-Angiotensin System - drug effects; Retrospective Studies; Time Factors; Treatment Outcome; α-blockers
• ISSN: 1064-1963; 1525-6006
• DOI: 10.3109/10641960902927960

Many guidelines recommended strict blood pressure (BP) control to prevent cardiovascular events. However, BP control in a substantial majority of hypertensives remains to be insufficient. We have determined the trends of BP control of the same patients during 15 years in a hypertension clinic. One hundred three patients (age 32-91, mean 68 ± 11 years in 2006), who were followed at our hypertension clinic between 1991-2006, were retrospectively investigated. We compared the clinical characteristics of the patients in 2006 to those in 1991, 1996, and 2001, using the averaged BP determined at two occasions of each year for our analysis. The average BP decreased from 144 ± 17 87 ± 10 mmHg to 132 ± 12 75 ± 10 mmHg (p < 0.01) during the 15 years between 1991 and 2006. When good BP control was defined as < 140 90 mmHg, the rate of patients with good BP control increased from 35% in 1991 to 45% in 1996, to 54% in 2001 (p < 0.01 vs. 1991), and to 72% in 2006 (p < 0.01 vs. 1991). The number of anti-hypertensive drugs used in 2006 significantly increased compared to those in 1991, 1996, and 2001. More specifically, the use of diuretics and α-blockers increased significantly during this period. Results suggest that BP control improved in the 15 years studied, and the increased use of the anti-hypertensive drugs, as well as the increased awareness of the importance of strict BP control, seems to have contributed to improve the BP control.