Key result
Between 2001 and 2010, beta-blocker prescriptions decreased from 41.5% to 21.5%, while ARB prescriptions increased from 0.5% to 1.0% (P<0.001 for trend).
Observational (n=223,287)
Yes
p-value: p=<0.001
Over a 10-year period in Hong Kong, antihypertensive prescription patterns shifted significantly, with a marked decrease in beta-blocker use and a slight increase in ARB use, particularly among younger patients.
These trends should not yet change practice; leaves open drivers and cardiovascular outcomes of shifting prescriptions.
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.
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Wong et al. (2013) conducted an observational in Hypertension (n=223,287). Antihypertensive prescriptions was evaluated on Trends in prescription proportions of antihypertensive drug classes (p=<0.001). Between 2001 and 2010, beta-blocker prescriptions decreased from 41.5% to 21.5%, while ARB prescriptions increased from 0.5% to 1.0% (P<0.001 for trend).
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