Comprehensive Trends and Patterns of Antihypertensive Prescriptions Using a Nationwide Claims Database in Korea

Figures

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  Figure 1. The flowchart for patient selection. Notes: Of the entire population of 50 million Koreans, patients who have taken oral antihypertensive medications over 30 days without any limited therapeutic indications including hypertension, were included on a yearly basis between 2015 and 2017.

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  Figure 2. Prescription trends of antihypertensive therapies stratified by sex and age in 2017. Notes: After stratification by sex and age in 2017, patients prescribed antihypertensive medications were shown. In contrast with participants <70 years, women >70 years were more likely to receive antihypertensive medications than men >70 years.

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  Figure 3. Prescription rates of antihypertensive medications stratified by year and age compared to total insured Koreans using data from KOSIS. Notes: The number of insured people by Korea’s National Health Insurance for every year was shown on the top of each bar according to age. The red portion of each bar was the prescription rate of antihypertensive medications and the blue portion of each bar was the proportion of people without antihypertensive medications. The prescription rate of antihypertensive medications among the entire insured Korean population, stratified by age groups, was estimated to evaluate the prescription magnitude of the drugs. The prescription rate was calculated as the number of patients with antihypertensives divided by the total number of insured people per age stratification. Subjects aged ≥70 showed the highest prescription rate of antihypertensives compared with those <70 years; however, a decreasing trend presented from 62.3% in 2015 to 54.2% in 2017. Abbreviation: KOSIS, Korean Statistical Information Service.

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  Figure 4. Distribution of age and prescription of antihypertensive medications presented by 100% stacked row graphs. Notes: Other: alpha-blockers or vasodilators. In 2017, an increasing trend in CCB use was observed with increasing age from 4.9% in subjects <30 years to 19.1% in those ≥70 years. By contrast, BB monotherapy was the most frequently prescribed (55.1%) among those <30, and a decreasing trend in BB use (4.2% for >70) was found with increasing age. The similar distributions of antihypertensive medication use per age group were shown from 2015 to 2017. Abbreviations: ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin II receptor blockers; BB, beta blockers; CCB, calcium channel blockers; DU, diuretics.

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  Figure 5. Changes in the pattern of antihypertensive medications presented by 100% stacked row graphs compared to the previous year in 2017 vs 2016. Notes: Other: alpha-blockers or vasodilators. While changes arose in the patterns of antihypertensive medication use during the study period, they were similar from year to year. The treatment change in each patient was tracked and analyzed from year to year. Five categorized groups were identified as follows: (1) Consistent, continued the same therapy; (2) Switch, changed one or both medications to different classes; (3) Add-on, added one or more other drug classes to the existing therapy; (4) Drop-off, dropped at least one class from the existing therapy; and (5) Quit, dropped all classes from the existing therapy, and retained no use of antihypertensive medications the following year. Thus, with monotherapy, drop-off and quit were the same. Abbreviations: ACEI, angiotensin-converting enzyme inhibitors; ARB, angiotensin II receptor blockers; BB, beta blockers; CCB, calcium channel blockers; DU, diuretics.