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Kidney disease (KD) is a serious risk factor for cardiovascular event, and it is important to protect the heart and kidneys during treatment of the high blood pressure to prevent cardiovascular event. Japanese guideline (JSH2014) suggests using combination therapy to reduce the risk of comorbidities rather than high-dose monotherapy for the patients with cardiovascular disease and KD. Therefore, the present study assessed antihypertensive prescription patterns in Japanese patients with ischemic heart disease related diseases (IHDRD) and KD, and evaluated whether the prescription patterns match with the guideline-suggested therapies by analyzing the national insurance claims database (NDB). We extracted antihypertensive prescription patterns among Japanese IHDRD patients from the data of October 2011 of NDB, and examined the effect of KD on the prescription patterns. The number of prescribed antihypertensive was associated with KD among patients regardless of IHDRD. Patients with IHDRD and KD were more frequently prescribed combination therapy (calcium channel blockers/angiotensin II receptor blockers) than the calcium channel blocker monotherapy, based on the JSH2014. On the other hand, we did not observe the standard use of diuretics for patients with heart failure, which is suggested by the JSH2014. These findings suggested that patients with IHDRD and KD were frequently prescribed combination therapy to achieve its cardioprotective and renoprotective effects, according to the JSH2014, but the prescription profile to the patients with heart failure didn't match that of guideline-suggested therapies. This study provided a clinically important information and demonstrated the utility of NDB for compliance assessment for therapeutics guideline.

The Survey of the Compliance Situation to the Antihypertensive Therapy Guideline by Analyzing Japanese National Claims Data