Japan Medical Office, Takeda Pharmaceutical Co. Ltd, Tokyo, Japan.
Division of Cardiology, Nephrology, Pulmonology and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
Hypertens Res. 2020 May;43(5):450-462. doi: 10.1038/s41440-020-0398-0. Epub 2020 Jan 29.
We conducted a survey to examine the gaps between Japanese physician and patient perspectives on hypertension management and to investigate important factors that may help solve the "hypertension paradox" in Japan. Web-based surveys of patients and physicians were conducted in Japan between October 19 and 31, 2017. The data collected included physician and patient perspectives on hypertension education, adherence to lifestyle modifications and antihypertensive medication, and reasons for treatment adherence/nonadherence. Factors relating to specific patient behaviors (e.g., monitoring their home blood pressure [BP] daily) were analyzed by multivariate logistic regression analysis. Of the 541 physicians and 881 patients included in the analyses, both groups recognized that the extent of lifestyle changes was insufficient. Approximately 80% of physicians reported that they fully or sufficiently provided education to patients about reasons for hypertension treatment and its associated risks, target BP levels, and lifestyle modifications. Only 40-50% of patients considered those topics having been fully or sufficiently discussed. Logistic regression analyses revealed that positive lifestyle modifications (daily home BP monitoring, salt intake <6 g/day, and daily aerobic exercise for ≥30 min) were positively associated with receiving feedback from physicians about specific lifestyle modifications and patient motivation for maintaining their target BP. In conclusion, perception of the amount of education provided by physicians on hypertension management was lower in patients than in physicians. In addition to effective regular follow-up regarding lifestyle modifications, patient motivation by physicians is an important factor for improving lifestyle modifications and achieving effective hypertension management in Japan.
我们进行了一项调查，以研究日本医生和患者在高血压管理方面的观点差距，并探讨可能有助于解决日本“高血压悖论”的重要因素。2017 年 10 月 19 日至 31 日，在日本通过网络对患者和医生进行了调查。收集的数据包括医生和患者对高血压教育、对生活方式改变和抗高血压药物的依从性以及治疗依从性/不依从的原因的看法。通过多变量逻辑回归分析，对与特定患者行为相关的因素（例如，每天监测自己的家庭血压[BP]）进行了分析。在纳入分析的 541 名医生和 881 名患者中，两组都认为生活方式的改变程度不足。大约 80%的医生报告说，他们充分或充分地向患者讲解了高血压治疗的原因及其相关风险、目标血压水平和生活方式改变。只有 40-50%的患者认为这些主题已经充分或充分讨论过。逻辑回归分析显示，积极的生活方式改变（每天家庭 BP 监测、盐摄入量<6 g/天和每天进行≥30 分钟的有氧运动）与从医生那里获得关于特定生活方式改变的反馈以及患者保持目标血压的动机呈正相关。总之，患者对医生提供的高血压管理教育的数量的看法低于医生。除了对生活方式改变进行有效的定期随访外，医生对患者的激励也是改善生活方式改变和在日本实现有效高血压管理的一个重要因素。
