title: Assessment of postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose.
abstract: BACKGROUND
  The number of antihypertensive drug classes cannot accurately reflect the total consumption of antihypertensive drugs used to control blood pressure. The defined daily dose has been adopted to permit consumption analysis of many prescribed drugs. The aim of the present study was to assess postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose as the unit of measurement.
  
  
  METHODS
  This retrospective study included 110 Japanese patients who underwent unilateral laparoscopic adrenalectomy between 1995 and 2012. Antihypertensive drug doses were calculated according to the standard of the defined daily dose recommended by the World Health Organization to compare drug use. After assessing postoperative changes in antihypertensive drug consumption, univariate and multivariate analyses were performed to identify clinical predictors for a 75% or greater decrease in the defined daily dose.
  
  
  RESULTS
  Consumption of antihypertensive drugs decreased postoperatively in 95.4% of patients. The median decrease in the defined daily dose was 76.8%. A postoperative decrease of 75% or greater in the defined daily dose was confirmed in 52.7% of patients. Multivariate analysis identified no medical history of cardiovascular disease, low body mass index, and short duration of hypertension as independent predictors of a postoperative decrease of 75% or greater in the defined daily dose.
  
  
  CONCLUSIONS
  The defined daily dose is a useful tool for assessing total changes in the consumption of antihypertensive drugs in patients with primary aldosteronism. Using the defined daily dose, clinicians could explain in detail to patients with primary aldosteronism the predicted postoperative change in antihypertensive drug consumption.
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan; Department of Urology, Toho University Sakura Medical Center, Sakura, Japan. Electronic address: p-cats@pd6.so-net.ne.jp.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Utsumi
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Imamoto
authors.affiliation: Department of Urology, Toho University Sakura Medical Center, Sakura, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Kamiya
authors.affiliation: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nagano
authors.affiliation: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Nihei
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center, Ichihara, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Naya
authors.affiliation: Department of Urology, Toho University Sakura Medical Center, Sakura, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ichikawa
mesh_terms: D000315:Adrenalectomy; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000188:drug therapy*; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents
keywords: Japanese; defined daily dose; hypertension; laparoscopic adrenalectomy; primary aldosteronism