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  • Special Issue: Current evidence and perspectives for hypertension management in Asia
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Achievement rate of target blood pressure in patients with hypertension treated by hypertension specialists and non-specialists in a real-world setting

Hypertension Research volume 46, pages 2460–2469 (2023)Cite this article

Abstract

Hypertension remains a major global healthcare issue. Considering that most Japanese patients with hypertension are managed by general practitioners, hypertension specialists should be involved in actual clinical practice. We investigated the blood pressure (BP), guidelines recommended for achievement rate of the target BP, and clinical variables of patients with hypertension treated by hypertension specialists and those treated by non-specialists in a real-world setting. Factors associated with the target BP achievement in this population were also investigated. Outpatients with hypertension from 12 medical facilities in Okinawa Prefecture were enrolled (n = 1469 [specialist group, 794; non-specialist group, 675]; mean age, 64.2 years; females, 45.8%). For all patients, BP and rate of the target BP achievement were 129.0 ± 15.5/74.6 ± 10.6 mmHg, and 51.8%, respectively. BP and the rate of target of BP achievement were 128.0 ± 15.1/73.4 ± 10.4 mmHg and 56.7% in the specialist group, and they were 130.1 ± 15.9/76.0 ± 10.8 mmHg and 46.1% in the non-specialist group. The urinary salt excretion and obesity rates were comparable between the specialist and non-specialist groups. Multivariable logistic analyses indicated that hypertension specialists and good medication adherence were positive factors, whereas obesity, chronic kidney disease, diabetes mellitus, and urinary salt excretion were inverse factors associated with target BP achievement in this population. Initiatives for salt reduction, medication adherence, and proper obesity management are crucial to improving BP management in patients with hypertension. Hypertension specialists are expected to play an essential role in them.

For all patients, the target blood pressure (BP) achievement rate were 51.8%. Hypertension specialists and good medication adherence were positive factors in achieving target BP; conversely, obesity, diabetes mellitus, chronic kidney disease, and high urinary salt excretion were inverse factors in achieving target BP among patients with hypertension.

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Acknowledgements

The authors are grateful for the cooperation of the staff of the collaborating medical facilities, particularly doctors Tamashiro M, Hata Y, Naka T, T. Kikumura, N. Nagayoshi, M. Tomori, C. Imai, M. Matsuoka, and Y. Shinzato. The authors are also grateful to our clinical research coordinators, particularly M. Kobayashi and M. Nakahodo for retrieving data from the facilities and F. Aniya and K. Kohama for their excellent assistance as nutritionists. In addition, the authors would like to thank Enago (www.enago.com) for the English language review.

Funding

This work was partly supported by the Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (Grant no. 2530891).

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Authors and Affiliations

  1. Health Administration Center, University of the Ryukyus, Okinawa, Japan

    Atsushi Sakima

  2. Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan

    Masanobu Yamazato, Akio Ishida, Tetsutaro Matayoshi & Yusuke Ohya

  3. Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan

    Kentaro Kohagura

  4. Shuri Jokamachi Clinic, Okinawa, Japan

    Takeshi Tana

  5. Nakamura Medical Clinic, Okinawa, Japan

    Yoshito Nakamura

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Correspondence to Atsushi Sakima.

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Sakima, A., Yamazato, M., Kohagura, K. et al. Achievement rate of target blood pressure in patients with hypertension treated by hypertension specialists and non-specialists in a real-world setting. Hypertens Res 46, 2460–2469 (2023). https://doi.org/10.1038/s41440-023-01362-3

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