Japanese Journal of Stroke
Online ISSN : 1883-1923
Print ISSN : 0912-0726
ISSN-L : 0912-0726
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Medical and Economic View on Antihypertensive Therapy
Yoichi OgushiShotai Kobayashi
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2008 Volume 30 Issue 6 Pages 943-947

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Abstract
1. Introduction Cost of antihypertensive therapy has increased constantly. It accounts 7.8% in total cost of medical treatments in japan. Cost of antihypertension drugs also accounts 12.5% in all kinds of medical drugs. Especially, angiotensin receptor blocker (ARB) is discussed to be set cheaper. We verified the performance of antihypertensive therapy with our cohort study.
2. Methods We performed (1) cohort study to compare blood pressure levels and total disease's mortality in general population, (2) calculated hazard rates of antihypertensive therapy in general population, and (3) odds ratio of hypertension and antihypertensive therapy between general population and patients with stroke.
3. Results The total mortality were in lowest level until SBP/DBP of 160/100 mmHg. The hazard rate in persons who had cure of hypertension and blood pressure more than 180/110 mmHg at the baseline was increased five times than that in persons who did not have the cure. Hypertension did not show risk of stroke for older people over 60 years. Hypertensive therapy was risk of stroke for younger and elder people.
4. Conclusion Severe antihypertensive therapy will cause increase of total mortality and incidence of stroke. The target of the therapy should be restricted to people who have hypertension over 160/100 mmHg without atrial fibrillation. We should not decrease acutely blood pressure beyond 20 mmHg by drugs.
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© 2008 The Japan Stroke Society
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