Treatment patterns of antihypertensive fixed-dose combinations according to age and number of agents prescribed: Retrospective analysis using a Japanese claims database.
AIM
To determine the real-world use of fixed-dose combinations (FDC) of antihypertensive agents using data collected from a nationwide medical database of acute hospitals in Japan.


METHODS
We carried out a retrospective analysis of data from the Medical Data Vision database for patients with hypertension who received an antihypertensive drug prescription between April 2014 and March 2015. The prescription rate of antihypertensive FDC were assessed by class, age and according to combinations.


RESULTS
In total, data from 59 867 patients aged 70.0 ± 11.9 years (mean ± SD) were analyzed. Patients were prescribed 1.9 ± 1.0 oral antihypertensive agents (mean ± SD). Overall, 58.6% of patients were prescribed two or more antihypertensive agents, and the most frequently prescribed classes were calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB). As the number of concomitant antihypertensive agents prescribed increased, the prescription rate of a CCB + an ARB FDC decreased, whereas the prescription rate of an ARB + a diuretic FDC increased. This trend was the same regardless of age. Of the 12 222 patients who were prescribed a CCB + an ARB, 26.0% received a FDC. In contrast, of the 922 patients prescribed an ARB + a thiazide diuretic, 80.6% received a FDC. Medium doses of both CCB and ARB agents, and low doses of diuretics were the most frequently prescribed for each class.


CONCLUSIONS
Our analyses show that the real-world use of FDC varies depending on the combination of agent class and the number of prescriptions; the latter was similar regardless of age. Geriatr Gerontol Int 2019; 19: 1077-1083.
['Ishida|Takayuki|T|https://orcid.org/0000-0003-1690-3899', 'Oh|Akinori|A|', 'Nishigaki|Nobuhiro|N|', 'Tsuchihashi|Takuya|T|']
D000328:Adult D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D057911:Angiotensin Receptor Antagonists D000959:Antihypertensive Agents D002121:Calcium Channel Blockers D016208:Databases, Factual D004232:Diuretics D004338:Drug Combinations D004363:Drug Utilization D005260:Female D006801:Humans D006973:Hypertension D007564:Japan D008297:Male D008875:Middle Aged D012189:Retrospective Studies D055815:Young Adult
fixed-dose combinations Japan hypertension antihypertensive drugs prescription status