Abstract
Antihypertensive drugs in prescriptions were investigated in 2, 604 patients (1, 572 males and 1, 032 females; mean age 62.3±11.9 years old; mean±SD) undergoing renal replacement therapy in 9 hospitals. Differences in the numbers of prescribed antihypertensive drugs at diagnosis, kind of renal replacement therapy, duration of renal replacement therapy, age, and gender were investigated. Some type of antihypertensive medication was prescribed to 63.7% of the patients, and the most frequently prescribed species of antihypertensive drugs was Ca antagonist in 50.9%, followed by angiotensin receptor blocker in 23.9%, angiotensin converting enzyme inhibitor 15.9%, α blocker in 12.9%, β blocker in 10.0%, and other antihypertensive drugs in 3.2%.
Mean number of prescribed antihypertensive drugs in the DM group (n=747) was 1.49±1.26 drugs, which was significantly higher than that in the non DM group (1.11±1.20 drugs; p<0.0001). Although there was no difference between genders in the overall number of prescribed drugs, the mean number of antihypertensive drugs prescribed was significantly higher in males (1.36±1.27 drugs) than in females (1.01±1.14 drugs; p<0.0001).
There was a tendency for the number of prescribed drugs to decrease with increased duration of hemodialysis therapy, especially in patients with more than 15 years of dialysis, the total number of prescribed drugs was significantly decreased. The ratio of the number of prescribed antihypertensive drugs to the overall numbers of prescribed drugs decreased with aging.
Furthermore, multiple regression analysis showed that DM, male, youth, short duration of hemodialysis were the main factors affecting the numbers of prescribed antihypertensive drugs. The number of prescribed antihypertensive drugs decreased with increased duration of hemodialysis therapy. However, the mean age of the group with the longest duration of hemodialysis was significantly younger than that of other groups, it was speculated that the mechanism involved in the decrease in the number of prescribed antihypertensive drugs might differ with increased duration of hemodialysis and aging.
