Achievement rate of target blood pressure in patients with hypertension treated by hypertension specialists and non-specialists in a real-world setting.
Clinical practice
Hypertension specialist
Obesity
Salt
Target blood pressure
Journal
Hypertension research : official journal of the Japanese Society of Hypertension
ISSN: 1348-4214
Titre abrégé: Hypertens Res
Pays: England
ID NLM: 9307690
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
10
02
2023
accepted:
15
06
2023
revised:
13
06
2023
medline:
7
11
2023
pubmed:
7
7
2023
entrez:
6
7
2023
Statut:
ppublish
Résumé
Hypertension remains a major global healthcare issue. Considering that most Japanese patients with hypertension are managed by general practitioners, hypertension specialists should be involved in actual clinical practice. We investigated the blood pressure (BP), guidelines recommended for achievement rate of the target BP, and clinical variables of patients with hypertension treated by hypertension specialists and those treated by non-specialists in a real-world setting. Factors associated with the target BP achievement in this population were also investigated. Outpatients with hypertension from 12 medical facilities in Okinawa Prefecture were enrolled (n = 1469 [specialist group, 794; non-specialist group, 675]; mean age, 64.2 years; females, 45.8%). For all patients, BP and rate of the target BP achievement were 129.0 ± 15.5/74.6 ± 10.6 mmHg, and 51.8%, respectively. BP and the rate of target of BP achievement were 128.0 ± 15.1/73.4 ± 10.4 mmHg and 56.7% in the specialist group, and they were 130.1 ± 15.9/76.0 ± 10.8 mmHg and 46.1% in the non-specialist group. The urinary salt excretion and obesity rates were comparable between the specialist and non-specialist groups. Multivariable logistic analyses indicated that hypertension specialists and good medication adherence were positive factors, whereas obesity, chronic kidney disease, diabetes mellitus, and urinary salt excretion were inverse factors associated with target BP achievement in this population. Initiatives for salt reduction, medication adherence, and proper obesity management are crucial to improving BP management in patients with hypertension. Hypertension specialists are expected to play an essential role in them. For all patients, the target blood pressure (BP) achievement rate were 51.8%. Hypertension specialists and good medication adherence were positive factors in achieving target BP; conversely, obesity, diabetes mellitus, chronic kidney disease, and high urinary salt excretion were inverse factors in achieving target BP among patients with hypertension.
Identifiants
pubmed: 37414873
doi: 10.1038/s41440-023-01362-3
pii: 10.1038/s41440-023-01362-3
doi:
Substances chimiques
Sodium Chloride, Dietary
0
Sodium Chloride
451W47IQ8X
Antihypertensive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2460-2469Informations de copyright
© 2023. The Author(s), under exclusive licence to The Japanese Society of Hypertension.
Références
Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2019). Hypertens Res. 2019;42:1235–481.
doi: 10.1038/s41440-019-0284-9
pubmed: 31375757
Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Hypertension. 2018;71:e13–e115.
pubmed: 29133356
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104.
doi: 10.1093/eurheartj/ehy339
pubmed: 30165516
Phillips LS, Branch WT, Cook CB, Doyle JP, El-Kebbi IM, Gallina DL, et al. Clinical inertia. Ann Intern Med. 2001;135:825–34.
doi: 10.7326/0003-4819-135-9-200111060-00012
pubmed: 11694107
Obara T, Ubeda SR, Ohkubo T, Matsuura H, Ishimitsu T, Takata M, et al. Awareness of the Japanese Society of Hypertension guidelines for the management of hypertension and their use in clinical practices: 2009 survey results. Hypertens Res. 2015;38:400–4.
doi: 10.1038/hr.2015.21
pubmed: 25832921
Mogi M, Hasebe N, Horiuchi M, Shimamoto K, Umemura S. The results of a survey of physicians about the Japanese Society of Hypertension guidelines for the management of hypertension 2014 and its clinical use. Hypertens Res. 2016;39:660–3.
doi: 10.1038/hr.2016.42
pubmed: 27169398
Yoshida T, Nishigaki N, Saita S, Shimasaki Y, Hasebe N. Perspectives of patients and physicians regarding hypertensive management from an online survey for excellence: a subanalysis of the PARADOX study by physician categories. Hypertens Res. 2020;43:431–41.
doi: 10.1038/s41440-019-0365-9
pubmed: 31996814
pmcid: 8075984
Yamazato M, Sakima A, Ishida A, Kohagura K, Matayoshi T, Tana T, et al. Salt and potassium intake evaluated with spot urine and brief questionnaires in combination with blood pressure control status in hypertensive outpatients in a real-world setting. Hypertens Res. 2021;44:1316–25.
doi: 10.1038/s41440-021-00707-0
pubmed: 34345011
Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.
doi: 10.1053/j.ajkd.2008.12.034
pubmed: 19339088
Japanese Society of Nephrology. Essential points from Evidence-based Clinical Practice Guidelines for Chronic Kidney Disease 2018. Clin Exp Nephrol. 2019;23:1–15.
doi: 10.1007/s10157-018-1648-1
Japanese Society of Nephrology. Evidence-Based Clinical Practice Guideline for CKD 2018. Tokyo: Tokyo Igakusha; 2018.
Tanaka T, Okamura T, Miura K, Kadowaki T, Ueshima H, Nakagawa H, et al. A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens. 2002;16:97–103.
doi: 10.1038/sj.jhh.1001307
pubmed: 11850766
Yasutake K, Miyoshi E, Kajiyama T, Umeki Y, Misumi Y, Horita N, et al. Comparison of a salt check sheet with 24-h urinary salt excretion measurement in local residents. Hypertens Res. 2016;39:879–85.
doi: 10.1038/hr.2016.79
pubmed: 27383507
Sakata S, Tsuchihashi T, Oniki H, Tominaga M, Arakawa K, Sakaki M, et al. Relationship between salt intake as estimated by a brief self-administered diet-history questionnaire (BDHQ) and 24-h urinary salt excretion in hypertensive patients. Hypertens Res. 2015;38:560–3.
doi: 10.1038/hr.2015.35
pubmed: 25787036
Sasaki S, Yanagibori R, Amano K. Self-administered diet history questionnaire developed for health education: a relative validation of the test-version by comparison with 3-day diet record in women. J Epidemiol. 1998;8:203–15.
doi: 10.2188/jea.8.203
pubmed: 9816812
Ohe K, Yasutake K, Murata Y, Tsuchihashi T, Enjoji M. Assessment of dietary salt and sodium intake: from device to questionnaire. Qual Prim Care. 2017;25:101–8.
Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, et al. The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res. 2009;32:3–107.
doi: 10.1038/hr.2009.34
pubmed: 19300436
Nishigaki N, Shimasaki Y, Yoshida T, Hasebe N. Physician and patient perspectives on hypertension management and factors associated with lifestyle modifications in Japan: results from an online survey. Hypertens Res. 2020;43:450–62.
doi: 10.1038/s41440-020-0398-0
pubmed: 31996815
pmcid: 8076050
Tsuchihashi T, Ishimitsu T, Ando K, Kusaka M, Ichihara A, Miura K, et al. JSH Statement: Tokyo declaration promoting salt reduction by the Japanese Society of Hypertension-the JSH Tokyo declaration. Hypertens Res. 2020;43:1133–4.
doi: 10.1038/s41440-020-0479-0
pubmed: 32475981
Tsuchihashi T. Dietary salt intake in Japan-past, present, and future. Hypertens Res. 2022;45:748–57.
doi: 10.1038/s41440-022-00888-2
pubmed: 35296804
Kario K, Nomura A, Harada N, Okura A, Nakagawa K, Tanigawa T, et al. Efficacy of a digital therapeutics system in the management of essential hypertension: the HERB-DH1 pivotal trial. Eur Heart J. 2021;42:4111–22.
doi: 10.1093/eurheartj/ehab559
pubmed: 34455443
pmcid: 8530534
Poulter NR, Borghi C, Parati G, Pathak A, Toli D, Williams B, et al. Medication adherence in hypertension. J Hypertens. 2020;38:579–87.
doi: 10.1097/HJH.0000000000002294
pubmed: 31834123
Choudhry NK, Kronish IM, Vongpatanasin W, Ferdinand KC, Pavlik VN, Egan BM, et al. Medication adherence and blood pressure control: a scientific statement from the American Heart Association. Hypertension. 2022;79:e1–e14.
doi: 10.1161/HYP.0000000000000203
pubmed: 34615363
Fukai K, Nagata T, Mori K, Ohtani M, Fujimoto K, Nagata M, et al. Validation of self-reported medication use for hypertension, diabetes, and dyslipidemia among employees of large-sized companies in Japan. J Occup Health. 2020;62:e12138.
doi: 10.1002/1348-9585.12138
pubmed: 32710699
pmcid: 7382304
Matsumoto M, Harada S, Iida M, Kato S, Sata M, Hirata A, et al. Validity assessment of self-reported medication use for hypertension, diabetes, and dyslipidemia in a pharmacoepidemiologic study by comparison with health insurance claims. J Epidemiol. 2021;31:495–502.
doi: 10.2188/jea.JE20200089
pubmed: 33361656
pmcid: 8328856
Fujita M, Sato Y, Nagashima K, Takahashi S, Hata A. Validity assessment of self-reported medication use by comparing to pharmacy insurance claims. BMJ Open. 2015;5:e009490.
doi: 10.1136/bmjopen-2015-009490
pubmed: 26553839
pmcid: 4654279
Hirawa N, Umemura S, Ito S. Viewpoint on guidelines for treatment of hypertension in Japan. Circ Res. 2019;124:981–3.
doi: 10.1161/CIRCRESAHA.119.314991
pubmed: 30920921
Carter BL, Rogers M, Daly J, Zheng S, James PA. The potency of team-based care interventions for hypertension: a meta-analysis. Arch Intern Med. 2009;169:1748–55.
doi: 10.1001/archinternmed.2009.316
pubmed: 19858431
pmcid: 2882164
Santschi V, Chiolero A, Colosimo AL, Platt RW, Taffé P, Burnier M, et al. Improving blood pressure control through pharmacist interventions: a meta-analysis of randomized controlled trials. J Am Heart Assoc. 2014;3:e000718.
doi: 10.1161/JAHA.113.000718
pubmed: 24721801
pmcid: 4187511
Siebenhofer A, Winterholer S, Jeitler K, Horvath K, Berghold A, Krenn C, et al. Long-term effects of weight-reducing drugs in people with hypertension. Cochrane Database Syst Rev. 2021;1:CD007654.
pubmed: 33454957
Lavie CJ, De Schutter A, Parto P, Jahangir E, Kokkinos P, Ortega FB, et al. Obesity and prevalence of cardiovascular diseases and prognosis-the obesity paradox updated. Prog Cardiovasc Dis. 2016;58:537–47.
doi: 10.1016/j.pcad.2016.01.008
pubmed: 26826295
Jahangir E, De Schutter A, Lavie CJ. Low weight and overweightness in older adults: risk and clinical management. Prog Cardiovasc Dis. 2014;57:127–33.
doi: 10.1016/j.pcad.2014.01.001
pubmed: 25216611
Childers DK, Allison DB. The ‘obesity paradox’: a parsimonious explanation for relations among obesity, mortality rate and aging? Int J Obes. 2010;34:1231–8.
doi: 10.1038/ijo.2010.71
Kudo N, Yokokawa H, Fukuda H, Sanada H, Miwa Y, Hisaoka T, et al. Achievement of target blood pressure levels among Japanese workers with hypertension and healthy lifestyle characteristics associated with therapeutic failure. PLoS One. 2015;10:e0133641.
doi: 10.1371/journal.pone.0133641
pubmed: 26225722
pmcid: 4520602
Miyagawa N, Okuda N, Nakagawa H, Takezaki T, Nishi N, Takashima N, et al. Socioeconomic status associated with urinary sodium and potassium excretion in Japan: NIPPON DATA2010. J Epidemiol. 2018;28:S29–34.
doi: 10.2188/jea.JE20170253
pubmed: 29503383
pmcid: 5825693
Iseki K, Iseki C, Itoh K, Uezono K, Sanefuji M, Ikemiya Y, et al. Urinary excretion of sodium and potassium in a screened cohort in Okinawa, Japan. Hypertens Res. 2002;25:731–6.
doi: 10.1291/hypres.25.731
pubmed: 12452326
Ministry of Health, Labour and Welfare of Japan. Overview of dietary reference intakes for Japanese. 2020. https://www.mhlw.go.jp/content/10900000/000862500.pdf . Accessed 1 February 2023.
WHO. Guideline: potassium intake for adults and children. Geneva: World Health Organization; 2009.
NCD Risk Factor Collaboration (NCD-RisC). Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. Lancet. 2019;394:639–51.
doi: 10.1016/S0140-6736(19)31145-6
Chow CK, Gupta R. Blood pressure control: a challenge to global health systems. Lancet. 2019;394:613–5.
doi: 10.1016/S0140-6736(19)31293-0
pubmed: 31327567
Kohro T, Furui Y, Mitsutake N, Fujii R, Morita H, Oku S, et al. The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome. Int Heart J. 2008;49:193–203.
doi: 10.1536/ihj.49.193
pubmed: 18475019
Kario K, Wang JG. Could 130/80 mm Hg Be adopted as the diagnostic threshold and management goal of hypertension in consideration of the characteristics of Asian Populations? Hypertension. 2018;71:979–84.
doi: 10.1161/HYPERTENSIONAHA.118.11203
pubmed: 29686008
Ohya Y, Kario K, Itoh H, Nishiyama A, Ishimitsu T, Ichihara A, et al. Statement of the Asian Hypertension Society Network: the Okinawa Declaration on the unity of hypertension societies in Asian countries and regions to overcome hypertension and hypertension-related diseases. Hypertens Res. 2022;45:1–2.
doi: 10.1038/s41440-021-00781-4
pubmed: 34750504