Associated Factors for Target Blood Pressure Achievement after Triple Combination Therapy in Hypertensive Patients

Article information

Korean J Health Promot. 2019;19(1):16-24

Publication date (electronic) : 2019 March 31

doi : https://doi.org/10.15384/kjhp.2019.19.1.16

Ye Rim Jeon ¹, So Hyun Jung ¹, Seo Young Kang ¹, Young Sik Kim ¹, Tae Hee Jeon ², Sangyeoup Lee ³, Yun-Jun Yang ⁴, Seon-Mee Kim ⁵, Jong Lull Yoon ⁶

¹Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

²Department of Family Medicine, Veterans Health Service Medical Center, Seoul, Korea.

³Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

⁴Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.

⁵Department of Family Medicine, Korea University Guro Hospital, Korea University School of Medicine, Seoul, Korea.

⁶Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

Corresponding author: Young Sik Kim, MD, MPH, PhD. Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-3811, Fax: +82-2-3010-3815, youngkim@amc.seoul.kr

Received 2019 January 21; Revised 2019 March 25; Accepted 2019 March 26.

Abstract

Background

The prevalence of hypertension reaches 29% in adults over 30 years of age in the Korean population; however, the control rate is merely 44%. The aim of this study was to investigate the associated factors for target blood pressure achievement after triple combination therapy in hypertensive patients.

Methods

From February 2016 to May 2018, 10 family physicians recruited 348 patients, who newly started a triple combination antihypertensive medication. Target blood pressure was defined as a systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg after 6 months of triple combination therapy. Multivariate logistic regression analyses were performed to analyze the associated factors for target blood pressure achievement.

Results

Among the 348 study participants, 317 completed 6 months of treatment. The target achievement rate was 76.3% (242/317). The mean absolute difference and 95% confidence interval (CI) for the SBP and DBP were 10.8 mmHg (8.8 to 12.7) and 6.4 mmHg (5.1 to 7.8), respectively (P<0.05). The odds ratio (OR) for the target blood pressure achievement increased in those with college education or higher (OR, 2.69; 95% CI, 1.22–5.92), those with dyslipidemia (OR, 1.74; 95% CI, 1.01–2.99), and those who were satisfied with the medication (OR, 29.91; 95% CI, 3.70–241.92).

Conclusions

The presence of dyslipidemia and patient's satisfaction with the medication were associated with target blood pressure achievement in our analyses. Our findings suggest the importance of patient's factor in the control of blood pressure.

Keywords: Hypertension; Combination drug therapy; Control; Blood pressure

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Table 1

Baseline characteristics of the 348 study participants

Abbreviations: BMI, body mass index; CVD, cardiovascular disease; DM, diabetes mellitus.

Values are presented as mean (standard deviation) or number (%).

Table 2

Changes in blood pressure after Sevikar HCT® (Daiichi Sankyo Europe GmbH, Pfaffenhofen, Germany) treatment

Abbreviations: AD, absolute difference; CI, confidence interval; HCT, hydrochlorothiazide; SD, standard deviation.

Table 3

Distribution of demographic and lifestyle factors according to achievement of target blood pressure goal

Abbreviations: BMI, body mass index; CVD, cardiovascular disease; DM, diabetes mellitus.

Values are presented as number (%).

^aP for trend is presented for (2×n) data.

Table 4

Multivariate logistic regression analyses predicting factors associated with target blood pressure goal

Abbreviation: CVD, cardiovascular disease.

Values are presented as odds ratio (95% confidence interval).

^aAdjusted for age, sex, and education.

Table 5

Patient's satisfaction with the Sevikar HCT® (Daiichi Sankyo Europe GmbH, Pfaffenhofen, Germany)

Values are presented as number (%).

Abbreviation: HCT, hydrochlorothiazide.