Improvement of blood pressure control in a hypertension clinic in Japan: A 15-year follow-up study

Many guidelines recommended strict blood pressure (BP) control to prevent cardiovascular events. However, BP control in a substantial majority of hypertensives remains to be insufficient. We have determined the trends of BP control of the same patients during 15 years in a hypertension clinic. One hundred three patients (age 3291, mean 68 ± 11 years in 2006), who were followed at our hypertension clinic between 19912006, were retrospectively investigated. We compared the clinical characteristics of the patients in 2006 to those in 1991, 1996, and 2001, using the averaged BP determined at two occasions of each year for our analysis. The average BP decreased from 144 ± 1787 ± 10 mmHg to 132 ± 1275 ± 10 mmHg (p < 0.01) during the 15 years between 1991 and 2006. When good BP control was defined as < 14090 mmHg, the rate of patients with good BP control increased from 35 in 1991 to 45 in 1996, to 54 in 2001 (p < 0.01 vs. 1991), and to 72 in 2006 (p < 0.01 vs. 1991). The number of anti-hypertensive drugs used in 2006 significantly increased compared to those in 1991, 1996, and 2001. More specifically, the use of diuretics and α-blockers increased significantly during this period. Results suggest that BP control improved in the 15 years studied, and the increased use of the anti-hypertensive drugs, as well as the increased awareness of the importance of strict BP control, seems to have contributed to improve the BP control.