Hypertension is the leading cardiovascular risk factor worldwide. However, in Japan, only 30% of patients have their blood pressure controlled under 140/90 mmHg, and nonadherence to antihypertensives is thought to be a reason for the poor control of hypertension. We therefore sought to assess the adherence to hypertension treatment and to evaluate factors influencing patients' adherence in a large, representative sample of the Japanese population. To this end, we analyzed claims data from the LIFE Study database, which includes 112 506 Japanese adults with newly diagnosed hypertension. Medication adherence was measured for a year postdiagnosis using the proportion of days covered (PDC) method. Factors associated with adherence to antihypertensives were also assessed. Among the total 112 506 hypertensive patients, the nonadherence rate (PDC ≤ 80%) for antihypertensives during the first year after initiation of the treatment was 26.2%. Younger age [31-35 years: odds ratio (OR), 0.15; 95% confidence interval (95% CI), 0.12-0.19 compared with 71-74-year-old patients], male gender, monotherapy, and diuretics use [OR, 0.87; 95% CI, 0.82-0.91 compared with angiotensin II receptor blockers (ARBs)] were associated with poor adherence in the present study. Cancer comorbidity (OR, 0.84; 95% CI, 0.79-0.91 compared with no comorbidity), prescription at a hospital, and living in a medium-sized to regional city were also associated with poor adherence. Our present findings showing the current status of adherence to antihypertensive medications and its associated factors using claims data in Japan should help to improve adherence to antihypertensives and blood pressure control.

中文翻译：

---

日本新诊断高血压患者的药物依从性和相关因素：生命研究。

高血压是全世界主要的心血管危险因素。然而，在日本，只有30%的患者血压控制在140/90 mmHg以下，不坚持服用降压药被认为是高血压控制不佳的原因之一。因此，我们试图在日本人群的大量代表性样本中评估高血压治疗的依从性，并评估影响患者依从性的因素。为此，我们分析了 LIFE 研究数据库的索赔数据，其中包括 112 506 名新诊断高血压的日本成年人。使用覆盖天数比例（PDC）方法测量诊断后一年的药物依从性。还评估了与坚持抗高血压药物相关的因素。在112 506名高血压患者中，开始治疗后第一年抗高血压药物不依从率（PDC≤80%）为26.2%。较年轻的年龄[31-35岁：比值比（OR），0.15；95% 置信区间 (95% CI)，0.12-0.19 与 71-74 岁患者相比]，男性，单一疗法和利尿剂使用 [OR，0.87；在本研究中，与血管紧张素 II 受体阻滞剂 (ARB) 相比，95% CI (0.82-0.91) 与依从性差相关。癌症合并症（OR，0.84；95% CI，与无合并症相比，95% CI，0.79-0.91）、在医院开处方以及居住在中型到边远城市也与依从性差有关。我们目前的研究结果显示了日本抗高血压药物依从性及其相关因素的现状，应有助于提高抗高血压药物的依从性和血压控制。