Association between Prescription and Control Status of Dyslipidemia and Hypertension among Japanese Patients with Diabetes
Aims: The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the “Specific Health Check and Guidance in Japan,” which was conducted from 2...
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| Published in | Journal of Atherosclerosis and Thrombosis Vol. 26; no. 9; pp. 805 - 820 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Japan
Japan Atherosclerosis Society
01.09.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1340-3478 1880-3873 1880-3873 |
| DOI | 10.5551/jat.47597 |
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| Abstract | Aims: The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the “Specific Health Check and Guidance in Japan,” which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.Methods: Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.Results: The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%–75% for LDL-C, and around 30%–40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.Conclusions: The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD. |
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| AbstractList | Aims:
The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the “Specific Health Check and Guidance in Japan,” which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.
Methods:
Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.
Results:
The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%–75% for LDL-C, and around 30%–40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.
Conclusions:
The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD. Aims: The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the “Specific Health Check and Guidance in Japan,” which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.Methods: Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.Results: The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%–75% for LDL-C, and around 30%–40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.Conclusions: The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD. The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the "Specific Health Check and Guidance in Japan," which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.AIMSThe proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the "Specific Health Check and Guidance in Japan," which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.METHODSSubjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%-75% for LDL-C, and around 30%-40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.RESULTSThe percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%-75% for LDL-C, and around 30%-40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD.CONCLUSIONSThe present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD. The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the "Specific Health Check and Guidance in Japan," which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status. Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF. The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%-75% for LDL-C, and around 30%-40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs. The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD. |
| Author | Fujimoto, Shouichi Narita, Ichiei Uno, Kenji Morita, Koji Asahi, Koichi Iseki, Kunitoshi Tsuruya, Kazuhiko Takahashi, Satoshi Ishikawa, Toshio Konta, Tsuneo Ohashi, Yasuo Sakamoto, Miki Okamura, Erina Watanabe, Tsuyoshi Moriyama, Toshiki Edo, Naoki Tsukamoto, Kazuhisa Kondo, Masahide Kimura, Kenjiro Yamagata, Kunihiro |
| Author_xml | – sequence: 1 fullname: Takahashi, Satoshi organization: Department of Internal Medicine, Teikyo University – sequence: 1 fullname: Tsukamoto, Kazuhisa organization: Department of Internal Medicine, Teikyo University – sequence: 1 fullname: Asahi, Koichi organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Kondo, Masahide organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Narita, Ichiei organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Sakamoto, Miki organization: Department of Internal Medicine, Teikyo University – sequence: 1 fullname: Yamagata, Kunihiro organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Konta, Tsuneo organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Fujimoto, Shouichi organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Morita, Koji organization: Department of Internal Medicine, Teikyo University – sequence: 1 fullname: Iseki, Kunitoshi organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Okamura, Erina organization: Department of Internal Medicine, Teikyo University – sequence: 1 fullname: Ohashi, Yasuo organization: Department of Integrated Science and Engineering for Sustainable Society, Chuo University – sequence: 1 fullname: Watanabe, Tsuyoshi organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Kimura, Kenjiro organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Edo, Naoki organization: Department of Internal Medicine, Teikyo University – sequence: 1 fullname: Ishikawa, Toshio organization: Department of Internal Medicine, Teikyo University – sequence: 1 fullname: Tsuruya, Kazuhiko organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Moriyama, Toshiki organization: Steering Committee for “Design of the comprehensive health care system for chronic kidney disease (CKD) based on the individual risk assessment by Specific Health Checkups” – sequence: 1 fullname: Uno, Kenji organization: Department of Internal Medicine, Teikyo University |
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| Cites_doi | 10.1007/s10157-011-0551-9 10.1016/j.atherosclerosis.2018.03.023 10.1038/hr.2012.186 10.5551/jat.GL2017 10.2337/diab.45.3.S14 10.5551/jat.15792 10.1001/archinternmed.2008.552 10.1056/NEJMoa021778 10.1016/j.atherosclerosis.2016.07.001 10.1056/NEJM199807233390404 10.1371/journal.pone.0108718 10.1001/jama.2016.3608 10.1056/NEJMoa0706245 10.1038/hr.2009.34 10.1038/hr.2014.20 10.5551/jat.31906 10.1016/j.amjcard.2014.02.033 10.1097/HJH.0000000000001399 |
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| Copyright | 2019 This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License. 2019 Japan Atherosclerosis Society 2019 |
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| References_xml | – reference: 14) Teramoto T, Uno K, Miyoshi I, Khan I, Gorcyca K, Sanchez RJ, Yoshida S, Mawatari K, Masaki T, Arai H, Yamashita S. Low-density lipoprotein cholesterol levels and lipid-modifying therapy prescription patterns in the real world: An analysis of more than 33,000 high cardiovascular risk patients in Japan. Atherosclerosis, 2016; 251: 248-254 – reference: 3) Fujishima M, Kiyohara Y, Kato I, Ohmura T, Iwamoto H, Nakayama K, Ohmori S, Yoshitake T. Diabetes and cardiovascular disease in a prospective population survey in Japan: The Hisayama Study. Diabetes, 1996; 45 Suppl 3: S14-16 – reference: 17) Ahmad Z. Statin intolerance. Am J Cardiol, 2014; 113: 1765-1771 – reference: 2) Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. 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| SubjectTerms | Aged Antihypertensive Agents - therapeutic use Atherosclerosis - epidemiology Atherosclerosis - prevention & control Atherosclerotic risk factors Cardiovascular high-risk patient Diabetes Mellitus - drug therapy Diabetes Mellitus - physiopathology Dyslipidemias - complications Dyslipidemias - drug therapy Female Follow-Up Studies Humans Hypertension - complications Hypertension - drug therapy Hypolipidemic Agents - therapeutic use Incidence Japan - epidemiology Japanese Male Original Prescription status Prescriptions - statistics & numerical data Prognosis |
| Title | Association between Prescription and Control Status of Dyslipidemia and Hypertension among Japanese Patients with Diabetes |
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