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

Takanobu Utsumi; Koji Kawamura; Takashi Imamoto; Naoto Kamiya; Hidekazu Nagano; Tomoaki Tanaka; Naoki Nihei; Yukio Naya; Hiroyoshi Suzuki; Tomohiko Ichikawa

doi:10.1016/j.asjsur.2014.01.011

Asian Journal of Surgery (Oct 2014)

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

Takanobu Utsumi,
Koji Kawamura,
Takashi Imamoto,
Naoto Kamiya,
Hidekazu Nagano,
Tomoaki Tanaka,
Naoki Nihei,
Yukio Naya,
Hiroyoshi Suzuki,
Tomohiko Ichikawa

Affiliations

Takanobu Utsumi: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
Koji Kawamura: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
Takashi Imamoto: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
Naoto Kamiya: Department of Urology, Toho University Sakura Medical Center, Sakura, Japan
Hidekazu Nagano: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan
Tomoaki Tanaka: Department of Clinical Cell Biology, Graduate School of Medicine, Chiba University, Chiba, Japan
Naoki Nihei: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
Yukio Naya: Department of Urology, Teikyo University Chiba Medical Center, Ichihara, Japan
Hiroyoshi Suzuki: Department of Urology, Toho University Sakura Medical Center, Sakura, Japan
Tomohiko Ichikawa: Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan

DOI: https://doi.org/10.1016/j.asjsur.2014.01.011
Journal volume & issue: Vol. 37, no. 4
pp. 190 – 194

Abstract

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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.

Published in Asian Journal of Surgery

ISSN: 1015-9584 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Medicine: Surgery
Website: http://www.journals.elsevier.com/asian-journal-of-surgery/

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