Prescription Trends of Initial Antihypertensive Medications among Treatment-Naïve Individuals in South Korea: A Retrospective Analysis

Introduction Managing hypertension effectively is crucial for preventing cardiovascular complications. This study investigates the prescribing trends of initial antihypertensive treatments in South Korea, focusing on the shift towards combination therapies, especially fixed-dose combinations, as recommended by current guidelines. Methods We retrospectively analyzed data from 59,950 treatment-naïve hypertension patients without significant comorbidities 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 Among the cohort, 55.7% received monotherapy, and 44.3% were initiated on combination therapy. There was a notable increase in the prescription of fixed-dose combinations from 73.8% in 2009 to 93.8% in 2020. ARBs and CCBs were the predominant choices, with a preference for ARBs over ACE inhibitors, possibly due to the lower risk of side effects such as cough. The trend towards fixed-dose combinations aligns with guidelines advocating for improved patient adherence and efficacy. Conclusions The evolving prescription trends in South Korea towards combination therapy, particularly fixed-dose combinations, reflect a commitment to aligning with international hypertension management guidelines. This adaptation underscores the importance of evidence-based practice in enhancing hypertension care. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial N/A ### Funding Statement This work was supported by a 2-Year Research Grant of Pusan National University ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Institutional Review Board of Pusan National University approved this study (PNU IRB/ 2023\_131\_HR). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes