title: Antihypertensive prescriptions over a 10-year period in a large Chinese population.
abstract: BACKGROUND
  International guidelines recommending antihypertensive prescriptions for the management of hypertension have been published in the past decade. Beta-blocker use was discouraged by a significant body of evidence and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) were found more effective among younger patients. This study aims to evaluate the trends in prescription profiles in a large Chinese population because patterns of antihypertensive agent dispensation represent important information for physicians and policymakers.
  
  
  METHODS
  From clinical databases consisting of all patient records in the public health-care system of Hong Kong, we examined all antihypertensive prescriptions according to the drug classes (thiazide diuretics, alpha-blockers, beta-blockers, calcium channel blockers (CCBs), ACEIs, ARBs, fixed-dose combinations, and polytherapy (2, ≥3)) between 2001 and 2010. We retrieved >6.3 million prescription episodes for 223,287 patients.
  
  
  RESULTS
  The average age of the patients was 59.9 years (SD = 17.6), and 54.8% were women. According to prescription episodes, the most commonly prescribed medications were beta-blockers (31.7%) and CCBs (29.2%), followed by ACEIs (13.9%), thiazide diuretics (5.0%), and alpha-blockers (4.5%). Between 2001 and 2010, the prescription proportions of beta-blockers decreased from 41.5% to 21.5%, whereas that of ARBs increased from 0.5% to 1.0% (P < 0.001, χ(2) test for trend). It was found that the decline of beta-blockers (71.0% to 35.4%) and increase in ARB prescriptions (0.4% to 1.0%) were particularly marked among younger subjects aged <55 years.
  
  
  CONCLUSIONS
  These findings provided information on the prescription patterns of antihypertensive agents in a large Chinese population. It sets a future research direction to study the various reasons influencing these drug class-specific trends.
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.forename: Wilson W S
authors.initials: WW
authors.lastname: Tam
authors.forename: Clement S K
authors.initials: CS
authors.lastname: Cheung
authors.forename: Ellen L H
authors.initials: EL
authors.lastname: Tong
authors.forename: Antonio C H
authors.initials: AC
authors.lastname: Sek
authors.forename: N T
authors.initials: NT
authors.lastname: Cheung
authors.forename: Bryan P Y
authors.initials: BP
authors.lastname: Yan
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
authors.forename: Sian M
authors.initials: SM
authors.lastname: Griffiths
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D012042:Registries; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents
keywords: antihypertensive agents; blood pressure; drug class; evidence-based practice; hypertension; prescriptions trends.