Japan Medical Affairs, Takeda Pharmaceutical Company Limited, Tokyo, Japan, Japan.
Department of Cardiology and Hypertension, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
Geriatr Gerontol Int. 2018 Jun;18(6):899-906. doi: 10.1111/ggi.13276. Epub 2018 Mar 6.
To analyze the current use of antihypertensive drug classes in Japanese hypertensive patients stratified by age, highlighting differences between older and younger patients.
A nationwide medical database was used to evaluate antihypertensive use in patients (aged ≥20 years) who had received a prescription for one or more antihypertensive drug as an outpatient from April 2014 to March 2015. Patients (n = 59 867) were age-stratified into three groups: <65 years (28.7%), 65-74 years (33.1%) and ≥75 years (38.2%).
The mean number of antihypertensive drugs prescribed for patients in the overall population was 1.9 ± 1.0, with no appreciable differences between age groups. The most commonly prescribed drug classes for all ages were calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB). CCB were prescribed more often than ARB in the 65-74 years (66.9% vs 60.5%) and ≥75 years (70.4% vs 56.8%) years age groups, and ARB were prescribed more often than CCB in patients aged <65 years (63.1% vs 61.9%). There were minimal differences by age in prescription rates for β-blockers, angiotensin-converting enzyme inhibitors and thiazide diuretics. ARB prescription rates were lower in patients aged ≥75 years with diabetes mellitus or renal disease than in younger age groups. Prescription rates for loop diuretics were higher in patients aged ≥75 years than in younger age groups, especially among those with renal disease.
Antihypertensive drugs selected for patients aged ≥75 years differed from those selected for younger patients, in particular CCB and loop diuretics (prescribed more often), and ARB (prescribed less often). Geriatr Gerontol Int 2018; 18: 899-906.
分析按年龄分层的日本高血压患者中抗高血压药物类别的当前使用情况，重点比较老年和年轻患者之间的差异。
使用全国性医疗数据库评估 2014 年 4 月至 2015 年 3 月期间接受一种或多种抗高血压药物处方（年龄≥20 岁）的门诊患者的抗高血压药物使用情况。患者（n=59867）按年龄分为三组：<65 岁（28.7%）、65-74 岁（33.1%）和≥75 岁（38.2%）。
总体人群中每位患者处方的抗高血压药物平均数量为 1.9±1.0，各年龄组之间无明显差异。所有年龄段最常开的药物类别是钙通道阻滞剂（CCB）和血管紧张素Ⅱ受体阻滞剂（ARB）。65-74 岁（66.9%比 60.5%）和≥75 岁（70.4%比 56.8%）年龄组中 CCB 的处方频率高于 ARB，而<65 岁的患者中 ARB 的处方频率高于 CCB（63.1%比 61.9%）。β受体阻滞剂、血管紧张素转换酶抑制剂和噻嗪类利尿剂的处方率随年龄的变化很小。患有糖尿病或肾脏疾病的≥75 岁患者的 ARB 处方率低于较年轻年龄组。与年轻年龄组相比，≥75 岁的患者中开环利尿剂的处方率更高，尤其是患有肾脏疾病的患者。
为≥75 岁患者选择的抗高血压药物与为年轻患者选择的药物不同，特别是 CCB 和袢利尿剂（更常开）和 ARB（更常不开）。老年医学与老年健康杂志 2018 年；18：899-906。
