PS-P07-11: TRENDS OF ANTIHYPERTENSIVE DRUG PRESCRIPTION AND BLOOD PRESSURE CHANGES BY PREFECTURE USING NATIONAL DATABASE OF HEALTH INSURANCE CLAIMS OF JAPAN

Abstract

Background: Blood pressure control is an important issue in extending the healthy life expectancy of the population. The Ministry of Health, Labour and Welfare's “Reference Data on the Promotion of Healthy Japan 21 (Second Phase)” set a target of a mean reduction of 4.2 mmHg in systolic blood pressure, but this target was not achieved from 1998 to 2009. Objective: The purpose of this study was to detect prefectures that have effectively lowered systolic blood pressure, and to discuss and examine effective countermeasures for hypertension. Methods: We analyzed prescription trends of antihypertensive drugs and changes in systolic blood pressure from the 1st to 6th national database of health insurance claims and specific health checkups of Japan (NDB) open data (specified health examinations from 2013 to 2018 and drug receipts from 2014 to 2019). Results: The average change in systolic blood pressure was calculated for each prefecture, and the prefecture with the greatest decrease in systolic blood pressure was Kagoshima Prefecture. Conversely, Yamanashi Prefecture showed the highest increase in systolic blood pressure. Further analysis of antihypertensive drug use revealed that the use of antihypertensive drugs in Kagoshima prefecture was 30.4% for men and 23.9% for women, which was higher than the national average (23.5% for men and 17.3% for women). Furthermore, the prescription rate of Angiotensin receptor blocker/calcium channel blocker (ARB/CCB) combination drugs in Kagoshima prefecture was found to be the highest in Japan at 27.3% (national average: 20.9%). Therefore, we examined the correlation between the prescription ratio of various antihypertensive drugs and mean change in systolic blood pressure, and found a significant negative correlation (r = -0.37 for males, p < 0.01; r = -0.29 for females, p < 0.05) between the prescription ratio of and mean change in systolic blood pressure in 2019. p < 0.05) was observed. On the other hand, th ARB/CCB combos ere was no clear correlation between ARB or Ca antagonist alone and mean change in systolic blood pressure. Based on these results, the increase in the prescription rate of ARB/CCB combos may have improved adherence to medication and blood pressure control. Conclusion: In addition to lifestyle modification, prescribing combination drugs may improve adherence to medication and be effective in combating hypertension.