title: A Survey of Actual Clinical Practice Concerning Blood Pressure Control among Patients with Hypertension in Kanagawa 2014.
abstract: We performed a cross-sectional survey to investigate actual clinical practice concerning blood-pressure control among patients with hypertension in Kanagawa. The guidelines of the Japanese Society of Hypertension (JSH) for the management of patients with hypertension were revised in 2014. From October 1 to November 30, 2014, questionnaires on the care of patients with hypertension were sent via post to members of the Kanagawa Physicians Association in Kanagawa Prefecture, Japan. -Data on 1,105 patients (mean age: 68.4±12.3 years, 537 men and 568 women) were obtained. The overall mean systolic blood pressure (BP) of these patients was 128.7±12.1 mmHg for home monitoring and 132.9±12.6 mmHg for office monitoring; diastolic BP was 75.7±9.7 for home monitoring and 77.0±9.7 mmHg for office monitoring. According to the JSH 2014 guidelines, the target BP was achieved by 68.1% of all subjects; 89.2% of late-phase elderly patients (75 years or older); 69.1% of young, middle-aged, and early-phase elderly patients (younger than 75 years except in patients with diabetes mellitus [DM] or chronic kidney disease [CKD] with proteinuria); 9.3% of patients with DM except late-phase elderly patients; and 11.9% of CKD patients with proteinuria except DM. Cross-sectional analysis showed that the factors significantly associated with an increased likelihood of achieving the target BP were as follows: 1) good medication compliance even for a small number of antihypertensive agents at small amount of doses in patients 75 years and older; 2) good medication compliance in patients in younger than 75 years; 3) an older age, a larger proportion in the female-to-male ratio and a lower body mass index in patients with DM except late-phase elderly patients; and 4) usage of a large number of antihypertensive agents in CKD patients with proteinuria. Further follow-up surveys are necessary to investigate changes in clinical practice following the introduction of the revised guidelines.
authors.affiliation: The Kanagawa Physicians Association.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hatori
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakai
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Sato
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyajima
authors.forename: Shouhei
authors.initials: S
authors.lastname: Yuasa
authors.forename: Shingo
authors.initials: S
authors.lastname: Kuboshima
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kajiwara
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Hara
authors.forename: Kousuke
authors.initials: K
authors.lastname: Minamizawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyakawa
mesh_terms: D000368:Aged; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000473:pathology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D051436:Renal Insufficiency, Chronic / Q000150:complications