-Original-

A Survey of Actual Clinical Practice Concerning Blood Pressure Control among Patients with Hypertension in Kanagawa 2014

Nobuo Hatori, Hiroyuki Sakai, Kazuyoshi Sato, Masayuki Miyajima, Shouhei Yuasa, Shingo Kuboshima, Keiichi Kajiwara, Yoshikuni Hara, Kousuke Minamizawa and Masaaki Miyakawa

The Kanagawa Physicians Association, Kanagawa, Japan

We performed a cross-sectional survey to investigate actual clinical practice concerning blood-pressure control among patients with hypertension in Kanagawa. The guidelines of the Japanese Society of Hypertension (JSH) for the management of patients with hypertension were revised in 2014. From October 1 to November 30, 2014, questionnaires on the care of patients with hypertension were sent via post to members of the Kanagawa Physicians Association in Kanagawa Prefecture, Japan. -Data on 1,105 patients (mean age: 68.4±12.3 years, 537 men and 568 women) were obtained. The overall mean systolic blood pressure (BP) of these patients was 128.7±12.1 mmHg for home monitoring and 132.9±12.6 mmHg for office monitoring; diastolic BP was 75.7±9.7 for home monitoring and 77.0±9.7 mmHg for office monitoring. According to the JSH 2014 guidelines, the target BP was achieved by 68.1% of all subjects; 89.2% of late-phase elderly patients (75 years or older); 69.1% of young, middle-aged, and early-phase elderly patients (younger than 75 years except in patients with diabetes mellitus [DM] or chronic kidney disease [CKD] with proteinuria); 9.3% of patients with DM except late-phase elderly patients; and 11.9% of CKD patients with proteinuria except DM. Cross-sectional analysis showed that the factors significantly associated with an increased likelihood of achieving the target BP were as follows: 1) good medication compliance even for a small number of antihypertensive agents at small amount of doses in patients 75 years and older; 2) good medication compliance in patients in younger than 75 years; 3) an older age, a larger proportion in the female-to-male ratio and a lower body mass index in patients with DM except late-phase elderly patients; and 4) usage of a large number of antihypertensive agents in CKD patients with proteinuria. Further follow-up surveys are necessary to investigate changes in clinical practice following the introduction of the revised guidelines.

J Nippon Med Sch 2016; 83: 188-195

Keywords
blood pressure, physicians, guidelines

Correspondence to
Nobuo Hatori, MD, Kobayashi Hospital, 1-14-18 Sakaecho, Odawara, Kanagawa 250-0011, Japan
hatnobu@pa2.so-net.ne.jp

Received, January 16, 2016
Accepted, April 21, 2016