title: Current usage of diuretics among hypertensive patients in Japan: the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study.
abstract: In the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME) study, we examined the current situation with respect to the prescription of diuretics, including the prevalence of diuretic treatment and the dosages used for patients with essential hypertension in primary care settings. Of the 3,400 hypertensive patients included in the study, 315 (9.3%) patients (mean age: 66.9+/-10.4 years; males: 43.5%) were prescribed diuretics. Compared with patients who were not using diuretics, those who were using diuretics were more obese and had more complications. The most commonly prescribed diuretic among the 331 prescriptions in the 315 diuretic users was trichlormethiazide (44%), followed by indapamide (15%) and spironolactone (14%). Among patients being treated with diuretics, monotherapy was used in only 5% of patients; in the majority of patients combination therapy including diuretics (95%) was used. Relatively low dosages of diuretics were generally used. There was a difference between the actual dosages prescribed and those recommended by the Japanese Society of Hypertension (JSH) guidelines or the product information approved in Japan. Compared with previous estimates of the prevalence of diuretic use in hypertensives in Japan (4.0-5.4%), the rate in the J-HOME study (9.3%) was higher. This may be attributable at least in part to the results of the many published, large-scale intervention trials confirming the clinical significance of diuretics. Although a relatively high dosage is recommended in the diuretic product information and in the JSH guidelines, dosages of diuretics should be reconsidered in Japan.
authors.affiliation: Department of Planning for Drug Development, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
authors.forename: Kayo
authors.initials: K
authors.lastname: Murai
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Takuya
authors.initials: T
authors.lastname: Oikawa
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Rie
authors.initials: R
authors.lastname: Komai
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Horikawa
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged
chemical_list: D004232:Diuretics