Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Clin Ther. 2021 Mar;43(3):602-612. doi: 10.1016/j.clinthera.2021.01.013. Epub 2021 Feb 23.
Antihypertensive agents are frequently prescribed in kidney transplant recipients (KTRs). However, the frequency and patterns of prescribing antihypertensive agents remain uncharacterized in KTRs in China. Therefore, this investigation was carried out.
Retrospective prescription data dated 2011 to 2018 from KTRs in China were accessed using the Hospital Prescription Analysis Program database. Information about sex, birth date, and identification number of the patient; city, date, and department of the medical visit; major diagnoses; and the generic names, specifications, quantities, and usage of prescribed drugs were collected. Antihypertensive agents were grouped into 5 classes: angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers (BBs), calcium channel blockers (CCBs), and diuretics. The frequency and patterns of prescribing these antihypertensive agents were analyzed.
Prescriptions from 174,749 KTRs (67.2% male; mean age, 42.5 [9.4] years) were obtained, and 58.2% of the patients were prescribed antihypertensive agents. The percentage of patients who received antihypertensive treatment increased from 52.9% in 2011 to 61.6% in 2018 and varied by city. Cyclosporine was associated with higher prescription frequency of antihypertensive agents than was tacrolimus (71.7% vs 63.4%; P < 0.0001). During the 8-year study period, CCBs were most frequently prescribed (39.0%), followed by ARBs (31.9%), BBs (14.3%), ACEIs (11.6%), and diuretics (3.2%). The mean (SD) number of antihypertensive drugs prescribed per KTR was 1.7 (0.8). Almost half of KTRs (51.2%) received just 1 antihypertensive drug. Co-administration of 2 or more antihypertensive drugs presented an obviously upward trend. The most commonly prescribed 2-drug combination was CCB + ARB (44.8%), followed by CCB + BB (20.1%) and CCB + ACEI (13.0%). In the patients who received 3 antihypertensive drugs, the 2 most frequently prescribed combinations were CCB + ARB + BB (37.5%) and CCB + ARB + ACEI (32.7%). Specific data varied by both year and city.
The prescribing patterns of antihypertensive agents in KTRs varied by city even within same country. Hence, more high-quality research studies on the use of antihypertensive agents in KTRs are needed.
降压药常被用于肾移植受者（KTRs）。然而，在中国的 KTRs 中，降压药的使用频率和模式仍未得到明确描述。因此，进行了这项调查。
使用医院处方分析程序数据库，获取了 2011 年至 2018 年中国 KTRs 的回顾性处方数据。收集了患者的性别、出生日期和识别号码；就诊城市、日期和科室；主要诊断；以及处方药物的通用名、规格、数量和使用情况。将降压药分为 5 类：血管紧张素转换酶抑制剂（ACEIs）、血管紧张素受体阻滞剂（ARBs）、β受体阻滞剂（BBs）、钙通道阻滞剂（CCBs）和利尿剂。分析了这些降压药的使用频率和模式。
共获得了 174749 名 KTRs 的处方（67.2%为男性；平均年龄 42.5[9.4]岁），其中 58.2%的患者接受了降压治疗。接受降压治疗的患者比例从 2011 年的 52.9%增加到 2018 年的 61.6%，且因城市而异。与他克莫司相比，环孢素与更高的降压药处方频率相关（71.7% vs 63.4%；P<0.0001）。在 8 年的研究期间，CCBs 是最常被开的药物（39.0%），其次是 ARBs（31.9%）、BBs（14.3%）、ACEIs（11.6%）和利尿剂（3.2%）。每位 KTR 开的降压药的平均（SD）数量为 1.7（0.8）。近一半的 KTRs（51.2%）只接受了 1 种降压药。同时使用 2 种或更多种降压药的趋势明显上升。最常开的 2 种药物组合是 CCB+ARB（44.8%），其次是 CCB+BB（20.1%）和 CCB+ACEI（13.0%）。在接受 3 种降压药的患者中，最常开的两种组合是 CCB+ARB+BB（37.5%）和 CCB+ARB+ACEI（32.7%）。具体数据因年份和城市而异。
KTRs 中降压药的使用模式因城市而异，即使在同一国家内也是如此。因此，需要更多高质量的研究来研究 KTRs 中降压药的使用情况。
