Korean J Health Promot.  2019 Mar;19(1):16-24. 10.15384/kjhp.2019.19.1.16.

Associated Factors for Target Blood Pressure Achievement after Triple Combination Therapy in Hypertensive Patients

Affiliations
  • 1Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. youngkim@amc.seoul.kr
  • 2Department of Family Medicine, Veterans Health Service Medical Center, Seoul, Korea.
  • 3Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.
  • 4Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
  • 5Department of Family Medicine, Korea University Guro Hospital, Korea University School of Medicine, Seoul, Korea.
  • 6Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.

Abstract

BACKGROUND
The prevalence of hypertension reaches 29% in adults over 30 years of age in the Korean population; however, the control rate is merely 44%. The aim of this study was to investigate the associated factors for target blood pressure achievement after triple combination therapy in hypertensive patients.
METHODS
From February 2016 to May 2018, 10 family physicians recruited 348 patients, who newly started a triple combination antihypertensive medication. Target blood pressure was defined as a systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg after 6 months of triple combination therapy. Multivariate logistic regression analyses were performed to analyze the associated factors for target blood pressure achievement.
RESULTS
Among the 348 study participants, 317 completed 6 months of treatment. The target achievement rate was 76.3% (242/317). The mean absolute difference and 95% confidence interval (CI) for the SBP and DBP were 10.8 mmHg (8.8 to 12.7) and 6.4 mmHg (5.1 to 7.8), respectively (P<0.05). The odds ratio (OR) for the target blood pressure achievement increased in those with college education or higher (OR, 2.69; 95% CI, 1.22-5.92), those with dyslipidemia (OR, 1.74; 95% CI, 1.01-2.99), and those who were satisfied with the medication (OR, 29.91; 95% CI, 3.70-241.92).
CONCLUSIONS
The presence of dyslipidemia and patient's satisfaction with the medication were associated with target blood pressure achievement in our analyses. Our findings suggest the importance of patient's factor in the control of blood pressure.

Keyword

Hypertension; Combination drug therapy; Control; Blood pressure
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