title: Blood pressure control and satisfaction of hypertensive patients following a switch to combined drugs of an angiotensin receptor blocker and a calcium channel blocker in clinical practice of nephrology.
abstract: BACKGROUND
  Combination drugs containing an angiotensin receptor blocker and a calcium channel blocker have been widely commercialized in recent years, and their advantages, such as improvements in adherence, and reductions in medication costs, have been greatly emphasized. However, the actual situations and the impact of switching to combination drugs in clinical practice of nephrology are not fully understood.
  
  
  METHODS
  This study was conducted in outpatients of nephrology who received antihypertensive medicines, and who switched to combination drugs. Changes in the potency of the antihypertensive drugs, and blood pressure were examined retrospectively before and after changing treatments. In addition, the study also involved patients' questionnaire, which examined changes in blood pressure at home, the presence or absence of missed doses, the impact on medication-related expenses, and the level of patients' satisfaction with regard to combination drugs.
  
  
  RESULTS
  Survey results from 90 participants revealed that changing to combination drugs resulted in a reduction of missed doses, a decrease in blood pressure measured in an outpatient setting, and a reduction in medication-related expenses in total patients, non-chronic kidney disease (CKD) patients, and CKD patients.
  
  
  CONCLUSIONS
  Our study shows that switching to combination antihypertensive drugs resulted in an improvement in adherence and a reduction in medication-related expenses, and revealed that patient satisfaction was high. Combination drugs for hypertensive patients may be beneficial in both medical and economical viewpoints.
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shiraishi
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Shuko
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kubo
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Shima
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Michito
authors.initials: M
authors.lastname: Nagura
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yano
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Yuh
authors.initials: Y
authors.lastname: Izumikawa
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Tomioka
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Hitonari
authors.initials: H
authors.lastname: Nosaka
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kojima
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tanemoto
authors.affiliation: Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan. s_uchida@netjoy.ne.jp.
authors.forename: Shunya
authors.initials: S
authors.lastname: Uchida
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage* / Q000191:economics; D001383:Azetidinecarboxylic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D001562:Benzimidazoles / Q000008:administration & dosage; D001565:Benzoates / Q000008:administration & dosage; D001713:Biphenyl Compounds; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000191:economics; D004095:Dihydropyridines / Q000008:administration & dosage; D004338:Drug Combinations; D016527:Drug Costs; D057915:Drug Substitution; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009398:Nephrology; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D000077333:Telmisartan; D013777:Tetrazoles / Q000008:administration & dosage; D000068756:Valsartan / Q000008:administration & dosage
chemical_list: D057911:Angiotensin Receptor Antagonists; D001562:Benzimidazoles; D001565:Benzoates; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D004338:Drug Combinations; D007093:Imidazoles; D013777:Tetrazoles; D017311:Amlodipine; D001383:Azetidinecarboxylic Acid; D000068756:Valsartan; C437965:olmesartan; C061679:azelnidipine; C081643:candesartan; D000077333:Telmisartan
keywords: Angiotensin receptor blockers; Blood pressure; Calcium channel blockers; Combination antihypertensive drugs; Hypertension