Utsumi Takanobu, Kawamura Koji, Imamoto Takashi, Kamiya Naoto, Nagano Hidekazu, Tanaka Tomoaki, Nihei Naoki, Naya Yukio, Suzuki Hiroyoshi, Ichikawa Tomohiko
Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Urology, Toho University Sakura Medical Center, Sakura, Japan.
Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Asian J Surg. 2014 Oct;37(4):190-4. doi: 10.1016/j.asjsur.2014.01.011. Epub 2014 Mar 15.
The number of antihypertensive drug classes cannot accurately reflect the total consumption of antihypertensive drugs used to control blood pressure. The defined daily dose has been adopted to permit consumption analysis of many prescribed drugs. The aim of the present study was to assess postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose as the unit of measurement.
This retrospective study included 110 Japanese patients who underwent unilateral laparoscopic adrenalectomy between 1995 and 2012. Antihypertensive drug doses were calculated according to the standard of the defined daily dose recommended by the World Health Organization to compare drug use. After assessing postoperative changes in antihypertensive drug consumption, univariate and multivariate analyses were performed to identify clinical predictors for a 75% or greater decrease in the defined daily dose.
Consumption of antihypertensive drugs decreased postoperatively in 95.4% of patients. The median decrease in the defined daily dose was 76.8%. A postoperative decrease of 75% or greater in the defined daily dose was confirmed in 52.7% of patients. Multivariate analysis identified no medical history of cardiovascular disease, low body mass index, and short duration of hypertension as independent predictors of a postoperative decrease of 75% or greater in the defined daily dose.
The defined daily dose is a useful tool for assessing total changes in the consumption of antihypertensive drugs in patients with primary aldosteronism. Using the defined daily dose, clinicians could explain in detail to patients with primary aldosteronism the predicted postoperative change in antihypertensive drug consumption.
抗高血压药物的种类数量并不能准确反映用于控制血压的抗高血压药物的总消耗量。限定日剂量已被用于许多处方药的消耗量分析。本研究的目的是以限定日剂量为计量单位，评估原发性醛固酮增多症患者术后抗高血压药物消耗量的变化。
这项回顾性研究纳入了1995年至2012年间接受单侧腹腔镜肾上腺切除术的110名日本患者。根据世界卫生组织推荐的限定日剂量标准计算抗高血压药物剂量，以比较药物使用情况。在评估术后抗高血压药物消耗量的变化后，进行单因素和多因素分析，以确定限定日剂量降低75%或更多的临床预测因素。
95.4%的患者术后抗高血压药物消耗量下降。限定日剂量的中位数下降了76.8%。52.7%的患者术后限定日剂量下降了75%或更多。多因素分析确定无心血管疾病病史、低体重指数和高血压病程短是术后限定日剂量下降75%或更多的独立预测因素。
限定日剂量是评估原发性醛固酮增多症患者抗高血压药物总消耗量变化的有用工具。使用限定日剂量，临床医生可以向原发性醛固酮增多症患者详细解释术后抗高血压药物消耗量的预测变化。
