Adherence and medication utilisation patterns of fixed-dose and free combination of angiotensin receptor blocker/thiazide diuretics among newly diagnosed hypertensive patients: a population-based cohort study

Levels of hypertension treatment and control have been noted to vary between Europe and North America, although direct comparisons with similar methods have not been undertaken. In this study, we sought to estimate the relative impact of hypertension treatment strategies in Germany, Sweden, England, Spain, Italy, Canada, and the United States by using sample surveys conducted in the 1990s. Hypertension was defined as a blood pressure of 160/95 mm Hg or 140/90 mm Hg, plus persons taking antihypertensive medication. "Controlled hypertension" was defined as a blood pressure less than threshold among persons taking antihypertensive medications. Among persons 35 to 64 years, 66% of hypertensives in the United States had their blood pressure controlled at 160/95 mm Hg, compared with 49% in Canada and 23% to 38% in Europe. Similar discrepancies were apparent at the 140/90 mm Hg threshold, at which 29% of hypertensives in the United States, 17% in Canada, and

This study reports the prevalence of hypertension, proportions of awareness, treatment, and control in the 2002 Taiwanese Survey on Hypertension, Hyperglycemia, and Hyperlipidemia (TwSHHH), and compared the changes of hypertension prevalence, awareness, treatment, and control in two recent nationwide surveys. TwSHHH is the second nationwide survey designed to assess the prevalence, awareness, treatment, and control of hyperglycemia, hyperlipidemia, and hypertension. The TwSHHH survey applied a multistage, stratified, and random sampling during 2002 with a total of 7566 participants. Among them, 3088 male and 3391 female participants were 19 years old and over and were selected from households throughout Taiwan. The data of Nutrition and Health Survey in Taiwan (NAHSIT), the first nationwide survey to assess disease and nutrition status during 1993-1996, was also applied to compare changes of the prevalence, awareness, treatment, and control of hypertension between the two surveys. Compared with the NAHSIT, the prevalence of hypertension on TwSHHH decreased significantly in female adults, between 1993-1996 and 2002. In both males and females of all age groups, the awareness, treatment, and control of hypertension significantly and substantially improved between NAHSIT and TwSHHH. These results also correlated in time with the implementation of National Health Insurance since 1995. The favorable changes in education and availability of care may account for improved control of hypertension and, possibly, its prevention. There was a significant improvement of hypertension awareness, treatment, and control in the TwSHHH survey compared with the NAHSIT survey in Taiwan.