Assessment of postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose

• Published in: Asian journal of surgery Vol. 37; no. 4; pp. 190 - 194
• Main Authors: Utsumi, Takanobu, Kawamura, Koji, Imamoto, Takashi, Kamiya, Naoto, Nagano, Hidekazu, Tanaka, Tomoaki, Nihei, Naoki, Naya, Yukio, Suzuki, Hiroyoshi, Ichikawa, Tomohiko
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.10.2014; Elsevier
• Subjects: Adrenalectomy; Adult; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - therapeutic use; defined daily dose; Dose-Response Relationship, Drug; Female; Humans; Hyperaldosteronism - complications; Hyperaldosteronism - drug therapy; hypertension; Hypertension - drug therapy; Hypertension - etiology; Japanese; laparoscopic adrenalectomy; Laparoscopy; Male; Middle Aged; Postoperative Period; primary aldosteronism; Retrospective Studies; Surgery; laparoscopic adrenalectomy; defined daily dose; hypertension; Japanese; primary aldosteronism
• ISSN: 1015-9584; 0219-3108
• DOI: 10.1016/j.asjsur.2014.01.011

Summary Background The number of antihypertensive drug classes cannot accurately reflect the total consumption of antihypertensive drugs used to control blood pressure. The defined daily dose has been adopted to permit consumption analysis of many prescribed drugs. The aim of the present study was to assess postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose as the unit of measurement. Methods This retrospective study included 110 Japanese patients who underwent unilateral laparoscopic adrenalectomy between 1995 and 2012. Antihypertensive drug doses were calculated according to the standard of the defined daily dose recommended by the World Health Organization to compare drug use. After assessing postoperative changes in antihypertensive drug consumption, univariate and multivariate analyses were performed to identify clinical predictors for a 75% or greater decrease in the defined daily dose. Results Consumption of antihypertensive drugs decreased postoperatively in 95.4% of patients. The median decrease in the defined daily dose was 76.8%. A postoperative decrease of 75% or greater in the defined daily dose was confirmed in 52.7% of patients. Multivariate analysis identified no medical history of cardiovascular disease, low body mass index, and short duration of hypertension as independent predictors of a postoperative decrease of 75% or greater in the defined daily dose. Conclusion The defined daily dose is a useful tool for assessing total changes in the consumption of antihypertensive drugs in patients with primary aldosteronism. Using the defined daily dose, clinicians could explain in detail to patients with primary aldosteronism the predicted postoperative change in antihypertensive drug consumption.