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  • Brief Communication
  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Antihypertensive drug prescription trends for pregnant women with hypertension in acute hospitals in Japan

Hypertension Research volume 45, pages 1441–1446 (2022)Cite this article

Abstract

Hypertensive disorders of pregnancy cause maternal organ damage. Therefore, appropriate management with antihypertensive medication is required from the first trimester. We aimed to clarify the antihypertensive drug prescription trends in pregnant women with hypertension in Japan. The administrative data of pregnant outpatients aged 16–49 years who visited acute hospitals between 2013 and 2020 were included. The annual antihypertensive drug prescription trends were evaluated based on their prescription proportions. The most prescribed drug in 2020 was nifedipine, followed by methyldopa and amlodipine. The proportion of nifedipine prescriptions significantly increased from 33.5 to 40.8% during the study period, whereas that of methyldopa significantly decreased from 16.6 to 11.6%. There was no change in the prescription trend of amlodipine. Dihydropyridine calcium channel blockers were the most commonly prescribed drug for pregnant women with hypertension.

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References

  1. Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2019). Hypertens Res. 2019;42:1235–481.

    Article  Google Scholar 

  2. Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72:24–43.

    Article  CAS  Google Scholar 

  3. Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2018;13:291–310.

    Article  CAS  Google Scholar 

  4. Rabi DM, McBrien KA, Sapir-Pichhadze R, Nakhla M, Ahmed SB, Dumanski SM, et al. Hypertension Canada’s 2020 comprehensive guidelines for the prevention, diagnosis, risk assessment, and treatment of hypertension in adults and children. Can J Cardiol. 2020;36:596–624.

    Article  Google Scholar 

  5. Ishikawa T, Obara T, Nishigori H, Miyakoda K, Ishikuro M, Metoki H, et al. Antihypertensives prescribed for pregnant women in Japan: prevalence and timing determined from a database of health insurance claims. Pharmacoepidemiol Drug Saf. 2018;27:1325–34.

    Article  Google Scholar 

  6. Ogihara T, Kikuchi K, Matsuoka H, Fujita T, Higaki J, Horiuchi M, et al. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2009). Hypertens Res. 2009;32:3–107.

    CAS  PubMed  Google Scholar 

  7. Shimamoto K, Ando K, Fujita T, Hasebe N, Higaki J, Horiuchi M, et al. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2014). Hypertens Res. 2014;37:253–390.

    Article  Google Scholar 

  8. World Health Organization. International statistical classification of diseases and related health problems 10th revision. 2019. https://icd.who.int/browse10/2019/en.

  9. Noh Y, Choe SA, Shin JY. A cohort study of antihypertensive use during pregnancy in South Korea, 2013-2017. Pregnancy Hypertens. 2020;22:167–74.

    Article  Google Scholar 

  10. Firoz T, Magee LA, MacDonell K, Payne BA, Gordon R, Vidler M, et al. Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review. BJOG. 2014;121:1210–8.

    Article  CAS  Google Scholar 

  11. Clark SM, Dunn HE, Hankins GD. A review of oral labetalol and nifedipine in mild to moderate hypertension in pregnancy. Semin Perinatol. 2015;39:548–55.

    Article  Google Scholar 

  12. National Institute for Health and Care Excellence. Hypertension in pregnancy: diagnosis and management NICE guideline [NG133]. 2019. https://www.nice.org.uk/guidance/ng133/chapter/recommendations.

  13. Mito A, Murashima A, Wada Y, Miyasato-Isoda M, Kamiya CA, Waguri M, et al. Safety of amlodipine in early pregnancy. J Am Heart Assoc. 2019;8:e012093.

    Article  CAS  Google Scholar 

  14. Nishigori H, Obara T, Nishigori T, Metoki H, Ishikuro M, Mizuno S, et al. Drug use before and during pregnancy in Japan: the Japan environment and children’s study. Pharmacy. 2017;5:21.

    Article  Google Scholar 

  15. Tita AT, Szychowski JM, Boggess K, Dugoff L, Sibai B, Lawrence K, et al. Treatment for mild chronic hypertension during pregnancy. N Engl J Med. 2022. https://doi.org/10.1056/NEJMoa2201295.

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Acknowledgements

We would like to thank Editage (www.editage.com) for writing support.

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Authors and Affiliations

  1. Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan

    Daisuke Kikuchi, Ryosuke Miura, Naoto Suzuki, Hiroyuki Hirakawa, Risa Josaka, Misato Ito, Misaki Tokunaga, Kensuke Usui & Kouji Okada

  2. Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan

    Taku Obara

  3. Department of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8573, Japan

    Taku Obara

  4. Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan

    Taku Obara

  5. Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan

    Kensuke Usui & Kouji Okada

Authors
  1. Daisuke Kikuchi
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  2. Taku Obara
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  3. Ryosuke Miura
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  4. Naoto Suzuki
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  5. Hiroyuki Hirakawa
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  6. Risa Josaka
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  7. Misato Ito
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  8. Misaki Tokunaga
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  9. Kensuke Usui
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  10. Kouji Okada
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Contributions

DK and TO were involved in the study design, data interpretation, and data analysis. All authors critically revised the report, commented on drafts of the manuscript, and approved the final manuscript.

Corresponding author

Correspondence to Taku Obara.

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The authors declare no competing interests.

Ethical approval

The Institutional Review Board of Tohoku Medical and Pharmaceutical University Hospital approved this study (approval number: 2021-2-080). Considering the study’s retrospective design and the anonymization of all personal data, the requirement for informed consent was waived.

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Kikuchi, D., Obara, T., Miura, R. et al. Antihypertensive drug prescription trends for pregnant women with hypertension in acute hospitals in Japan. Hypertens Res 45, 1441–1446 (2022). https://doi.org/10.1038/s41440-022-00956-7

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  • DOI: https://doi.org/10.1038/s41440-022-00956-7

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