Prescription Trends of Initial Antihypertensive Medications Among Presumed Treatment-Naïve Individuals in Korea: A Retrospective Analysis.

BACKGROUND: Hypertension is a major global health concern, closely linked to cardiovascular disease risks. This study assesses prescribing trends for initial antihypertensive therapy in South Korea, with a particular focus on the shift towards combination therapies, including fixed-dose combinations, as advocated by recent guidelines. METHODS: We retrospectively analyzed data from 59,950 presumed treatment-naïve hypertension patients without significant comorbidities, sourced from the National Patient Sample of the Health Insurance Review and Assessment Service, spanning 2009 to 2020. The study examined the prevalence of monotherapy versus combination therapy and the preferred classes of antihypertensive drugs. RESULTS: The analysis revealed that 55.7% of patients received monotherapy, while 44.3% were initiated on combination therapy. Notably, 87.3% of the combination therapy cohort were prescribed fixed-dose combinations. The study observed a consistent increase in the use of fixed-dose combinations and a notable preference for angiotensin receptor blocker (ARB) and ARB/calcium channel blocker regimens over time. Factors such as age, sex, and specific comorbidities influenced the likelihood of receiving combination therapy. CONCLUSION: The findings highlight a progressive shift towards combination antihypertensive therapies, particularly fixed-dose combinations, among presumed treatment-naïve patients in South Korea. This trend reflects a broader move in clinical practice towards more aggressive treatment strategies recommended by current hypertension guidelines. The study underscores the importance of personalized treatment approaches, taking into consideration individual patient characteristics.