Hypertension: Competing Treatments and Market Entry Considerations
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Today, approximately 1 billion people worldwide have high blood pressure, a figure expected to increase to 1.5 billion by 2025, affecting 1 in 3 adults over the age of 20 (Lancet. 2005;365:217-223). Hypertension is commonly seen in developing as well as developed countries and, where it remains untreated, presents a major risk factor for heart attack, stroke, kidney failure and other cardiovascular diseases. In a field where therapies are often unsatisfactory, physicians seek to extent their understanding and use of available treatments to improve patient outcomes. Knowledge in these areas is also important to drug developers, who seek a better understanding of prescribing practices and treatment needs and limitations from the clinician’s perspective, as part of their own efforts to develop more effective therapies. To meet interest in these areas, Biopharm Reports has conducted a global survey on current treatments and drug prescribing practices for Hypertension. This survey involved the participation of more than 280 clinical centres in 50 countries. In addition to drugs directly used to treat Hypertension (e.g. Diuretics, Calcium Channel Blockers), other drugs commonly prescribed to hypertensive patients (e.g. Statins), were also surveyed. See Clinical Survey, below. |
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Overview
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Clinical Survey
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Table of Contents
1. Introduction 5
2. Hypertension Therapy Survey 7
3. Survey Participants 14
4. Diagnosis (Sub-Types) 26
5. Single or Multiple Drugs 38
6. Drug Classes 43
7. Diuretics 57
8. Beta and Alpha Blockers 71
9. Adrenergic Receptor Agonists 87
10. Calcium Channel Blockers 95
11. ACE Inhibitors 106
12. Angiotension II Receptor Antagonists 116
13. Statins 123
14. Aldosterone Antagonists 130
15. Centrally Acting Drugs 135
16. Other Drugs 142
17. Drug Combinations 147
18. Combined Drug Formulations 158
19. Study Participants 172
Appendix 1 182
Figures
- Figure 3.1 Participant Countries
- Figure 3.2 Participating Clinics
- Figure 3.3 Participating physicians
- Figure 4.1 Mean percentage of patients diagnosed with different Hypertension subtypes
- Figure 4.2 Percentage of patients with normal blood pressure
- Figure 4.3 Percentage of patients with PreHypertension
- Figure 4.4 Percentage of patients with Stage 1 Hypertension
- Figure 4.5 Percentage of patients with Stage 2 Hypertension
- Figure 4.6 Percentage of patients with Isolated Systolic Hypertension
- Figure 4.7 Percentage of patients with Resistant Hypertension
- Figure 4.8 Percentage of patients with Drug-Induced Hypertension
- Figure 4.9 Percentage of patients with Pregnancy-Related Hypertension
- Figure 4.10 Percentage of patients with Exercise-Related Hypertension
- Figure 4.11 Percentage of patients with Other Secondary Hypertension
- Figure 4.12 Other types of secondary Hypertension reported in this study
- Figure 5.1 Percentage of patients receiving a single drug
- Figure 5.2 Percentage of patients receiving two or more drugs
- Figure 5.3 Percentage of patients receiving combined drug formulations
- Figure 5.4 Percentage of patients receiving other drug treatments
- Figure 5.1 Mean percentage of patients receiving single or multiple drugs
- Figure 6.1 Mean percentage of patients prescribed different drug classes for the treatment of Hypertension.
- Figure 6.2 Percentage of patients who receive Diuretics for the treatment of Hypertension
- Figure 6.3 Percentage of patients who receive Beta Blockers for the treatment of Hypertension
- Figure 6.4 Percentage of patients who receive Alpha Blockers for the treatment of Hypertension
- Figure 6.5 Percentage of patients receiving who receive Adrenergic Receptor Agonists for the treatment of Hypertension
- Figure 6.6 Percentage of patients who receive Calcium Channel Blockers for the treatment of Hypertension
- Figure 6.7 Percentage of patients who receive ACE Inhibitors for the treatment of Hypertension
- Figure 6.8 Percentage of patients who receive Angiotensin II Receptor Antagonists for the treatment of Hypertension
- Figure 6.9 Percentage of patients who receive Statins for the treatment of Hypertension
- Figure 6.10 Percentage of patients who receive Aldosterone Antagonists for the treatment of Hypertension
- Figure 6.11 Percentage of patients who receive Centrally Acting Drugs for the treatment of Hypertension
- Figure 6.12 Percentage of patients who receive Vasodilators for the treatment of Hypertension
- Figure 6.13 Percentage of patients who receive other drugs for the treatment of Hypertension
- Figure 7.1 Mean percentage of patients prescribed different diuretics for the treatment of Hypertension
- Figure 7.2 Percentage of patients prescribed the diuretic ethacrynic acid for the treatment of Hypertension
- Figure 7.3 Percentage of patients prescribed the diuretic torsemide for the treatment of Hypertension
- Figure 7.4 Percentage of patients prescribed the diuretic furosemide for the treatment of Hypertension
- Figure 7.5 Percentage of patients prescribed the diuretic bumetanide for the treatment of Hypertension
- Figure 7.6 Percentage of patients prescribed the diuretic epitizide for the treatment of Hypertension
- Figure 7.7 Percentage of patients prescribed the diuretic bendroflumethiazide for the treatment of Hypertension
- Figure 7.8 Percentage of patients prescribed the diuretic metolazone for the treatment of Hypertension
- Figure 7.9 Percentage of patients prescribed the diuretic hydrochlorothiazide for the treatment of Hypertension
- Figure 7.10 Percentage of patients prescribed the diuretic indapamide for the treatment of Hypertension
- Figure 7.11 Percentage of patients prescribed the diuretic chlorthalidone for the treatment of Hypertension
- Figure 7.12 Percentage of patients prescribed the diuretic chlorothiazide for the treatment of Hypertension
- Figure 7.13 Percentage of patients who receive The diuretic amiloride for the treatment of Hypertension
- Figure 7.14 Percentage of patients who receive The diuretic spironolactone for the treatment of Hypertension
- Figure 7.15 The percentage of patients who receive The diuretic triamterene for the treatment of Hypertension
- Figure 7.16 Percentage of patients who receive the diuretic triamterene/hydrochlorothiazide for the treatment of Hypertension
- Figure 7.17 Percentage of patients who receive the diuretic furosemide/spironolactone for the treatment of Hypertension
- Figure 7.18 Percentage of patients who receive other diuretic drugs for the treatment of Hypertension
- Figure 8.1 Mean percentage of patients receiving the top nine beta or alpha blockers for the treatment of Hypertension.
- Figure 8.2 Percentage of patients who receive atenolol for the treatment of Hypertension
- Figure 8.3 Percentage of patients who receive metoprolol for the treatment of Hypertension
- Figure 8.5 Percentage of patients who receive nadolol for the treatment of Hypertension
- Figure 8.5 Percentage of patients who receive nebivolol for the treatment of Hypertension
- Figure 8.6 Percentage of patients who receive oxprenolol for the treatment of Hypertension
- Figure 8.7 Percentage of patients who receive pindolol for the treatment of Hypertension
- Figure 8.8 Percentage of patients who receive propranolol the treatment of Hypertension
- Figure 8.9 Percentage of patients who receive carvedilol for the treatment of Hypertension
- Figure 8.10 Percentage of patients who receive bisoprolol for the treatment of Hypertension
- Figure 8.11Percentage of patients who receive timolol for the treatment of Hypertension
- Figure 8.12 Percentage of patients who receive ebivolol for the treatment of Hypertension
- Figure 8.13 Percentage of patients who receive acebutalol for the treatment of Hypertension
- Figure 8.14 Percentage of patients who receive betoxolol for the treatment of Hypertension
- Figure 8.15 Percentage of patients who receive carteolol for the treatment of Hypertension
- Figure 8.16 Percentage of patients who receive penbutolol for the treatment of Hypertension
- Figure 8.17 Percentage of patients who receive doxazosin for the treatment of Hypertension
- Figure 8.18 Percentage of patients who receive phentolamine for the treatment of Hypertension
- Figure 8.19 Percentage of patients who receive indoramin for the treatment of Hypertension
- Figure 8.20 Percentage of patients who receive phenoxybenzamine for the treatment of Hypertension
- Figure 8.21 Percentage of patients who receive prazosin for the treatment of Hypertension
- Figure 8.22 Percentage of patients who receive terazosin for the treatment of Hypertension
- Figure 8.23 Percentage of patients who receive labelalol for the treatment of Hypertension
- Figure 8.24 Percentage of patients who receive other drugs for the treatment of Hypertension
- Figure 9.1 Percentage of patients receiving adrenergic receptor agonists for the treatment of Hypertension.
- Figure 9.2 Percentage of patients who receive the adrenergic receptor agonist drug clonidine for the treatment of Hypertension
- Figure 9.3 Percentage of patients who receive the adrenergic receptor agonist drug methyldopa for the treatment of Hypertension
- Figure 9.4 Percentage of patients who receive the adrenergic receptor agonist drug rilmenidine for the treatment of Hypertension
- Figure 9.5 Percentage of patients who receive the adrenergic receptor agonist drug guanfacine for the treatment of Hypertension
- Figure 9.6 Percentage of patients who receive other adrenergic receptor agonists drugs for the treatment of Hypertension
- Figure 10.1 Mean percentage of patients receiving calcium channel blockers for the treatment of Hypertension.
- Figure 10.2 Percentage of patients who receive the calcium channel blocker nimodipine for the treatment of Hypertension
- Figure 10.3 The percentage of patients who receive the calcium channel blocker diltiazem for the treatment of Hypertension
- Figure 10.4 Percentage of patients who receive the calcium channel blocker amlodipine for the treatment of Hypertension
- Figure 10.5 Percentage of patients who receive the calcium channel blocker felodipine for the treatment of Hypertension
- Figure 10.6 The percentage of patients who receive the calcium channel blocker isradipine for the treatment of Hypertension
- Figure 10.7 Percentage of patients who receive the calcium channel blocker verapamil for the treatment of Hypertension
- Figure 10.8 Percentage of patients who receive the calcium channel blocker manidipine for the treatment of Hypertension
- Figure 10.9 Percentage of patients who receive the calcium channel blocker nisoldipine for the treatment of Hypertension
- Figure 10.10 Percentage of patients who receive the calcium channel blocker nicardipine for the treatment of Hypertension
- Figure 10.11 Percentage of patients who receive the calcium channel blocker nifedipine for the treatment of Hypertension
- Figure 10.12 Percentage of patients who receive the calcium channel blocker lercanidipine for the treatment of Hypertension
- Figure 10.13 Percentage of patients who receive the calcium channel blocker lacidipine for the treatment of Hypertension
- Figure 10.14 Percentage of patients who receive the calcium channel blocker nitrendipine for the treatment of Hypertension
- Figure 10.15 Percentage of patients who receive the calcium channel blocker clevidipine for the treatment of Hypertension
- Figure 10.16 Percentage of patients who receive other calcium channel blocker drugs for the treatment of Hypertension
- Figure 11.1 Mean percentage of patients receiving ACE inhibitors for the treatment of Hypertension.
- Figure 11.2 Percentage of patients who receive the ACE inhibitor captopril for the treatment of Hypertension
- Figure 11.3 Percentage of patients who receive the ACE inhibitor enalapril for the treatment of Hypertension
- Figure 11.4 Percentage of patients who receive the ACE inhibitor quinapril for the treatment of Hypertension
- Figure 11.5 Percentage of patients who receive the ACE inhibitor benzapril for the treatment of Hypertension
- Figure 11.6 Percentage of patients who receive the ACE inhibitor cilazapril for the treatment of Hypertension
- Figure 11.7 Percentage of patients who receive the ACE inhibitor ramipril for the treatment of Hypertension
- Figure 11.8 Percentage of patients who receive the ACE inhibitor perindopril for the treatment of Hypertension
- Figure 11.9 Percentage of patients who receive the ACE inhibitor lisinopril for the treatment of Hypertension
- Figure 11.10 Percentage of patients who receive the ACE inhibitor fosinopril for the treatment of Hypertension
- Figure 11.11 Percentage of patients who receive the ACE inhibitor trandolapril for the treatment of Hypertension
- Figure 11.12 Percentage of patients who receive the ACE inhibitor imidapril for the treatment of Hypertension
- Figure 11.13 Percentage of patients who receive the ACE inhibitor moexipril for the treatment of Hypertension
- Figure 11.14 Percentage of patients who receive other ACE inhibitors for the treatment of Hypertension
- Figure 12.1 Mean percentage of patients receiving Angiotension II receptor Antagonists for the treatment of Hypertension.
- Figure 12.2 Percentage of patients who receive the angiotension II receptor antagonist losartan for the treatment of Hypertension
- Figure 12.3 Percentage of patients who receive the angiotension II receptor antagonist olmesartan for the treatment of Hypertension
- Figure 12.4 Percentage of patients who receive the angiotension II receptor antagonist candesartan for the treatment of Hypertension
- Figure 12.5 Percentage of patients who receive the angiotension II receptor antagonist telmisartan for the treatment of Hypertension
- Figure 12.6 Percentage of patients who receive the angiotension II receptor antagonist eprosartan for the treatment of Hypertension
- Figure 12.7 Percentage of patients who receive the angiotension II receptor antagonist irbesartan for the treatment of Hypertension
- Figure 12.8 Percentage of patients who receive the angiotension II receptor antagonist valsartan for the treatment of Hypertension
- Figure 12.9 Percentage of patients who receive other angiotension II receptor antagonists for the treatment of Hypertension
- Figure 13.1 Mean percentage of patients receiving statins for the treatment of Hypertension.
- Figure 13.2 Percentage of patients who receive the statin drug atorvastatin of Hypertension
- Figure 13.3 Percentage of patients who receive the statin drug fluvaststin for the treatment of Hypertension
- Figure 13.4 Percentage of patients who receive the statin drug lovastatin for the treatment of Hypertension
- Figure 13.5 Percentage of patients who receive the statin drug pravastatin for the treatment of Hypertension
- Figure 13.6 Percentage of patients who receive the statin drug simvastatin for the treatment of Hypertension
- Figure 13.7 Percentage of patients who receive the statin drug rosuvastatin for the treatment of Hypertension
- Figure 13.8 Percentage of patients who receive other statin drugs for the treatment of Hypertension
- Figure 14.1 Mean percentage of patients receiving aldosterone antagonists for the treatment of Hypertension.
- Figure 14.2 Percentage of patients who receive the aldosterone antagonist drug eplerenone for the treatment of Hypertension
- Figure 14.3 Percentage of patients who receive the aldosterone antagonist drug spironolactone for the treatment of Hypertension
- Figure 14.4 Percentage of patients who receive other aldosterone antagonist drugs for the treatment of Hypertension
- Figure 15.1 Mean percentage of patients receiving centrally acting drugs for the treatment of Hypertension.
- Figure 15.2 Percentage of patients who receive the centrally acting drug clonidine for the treatment of Hypertension
- Figure 15.3 Percentage of patients who receive the centrally acting drug guanfacine for the treatment of Hypertension
- Figure 15.4 Percentage of patients who receive the centrally acting drug guanabenz for the treatment of Hypertension
- Figure 15.5 Percentage of patients who receive the centrally acting drug methyldopa for the treatment of Hypertension
- Figure 15.6 Percentage of patients who receive the centrally acting drug rilmenidine for the treatment of Hypertension
- Figure 15.7 Percentage of patients who receive the centrally acting drug moxonidine for the treatment of Hypertension
- Figure 15.8 Percentage of patients who receive other centrally acting drugs for the treatment of Hypertension
- Figure 16.1 Mean percentage of patients receiving the drug reserpine for the treatment of Hypertension.
- Figure 16.1 Mean percentage of patients receiving the drug aliskiren for the treatment of Hypertension.
- Figure 16.1 Mean percentage of patients receiving the drug rilmenidine for the treatment of Hypertension.
- Figure 16.1 Mean percentage of patients receiving the drug sodium nitroprusside for the treatment of Hypertension.
- Figure 16.1 Mean percentage of patients receiving the drug guanethidine for the treatment of Hypertension.
- Figure 17.1 Most frequently prescribed drug combinations for the treatment of Hypertension.
- Figure 17.2 Second most frequently prescribed drug combinations for the treatment of Hypertension.
- Figure 17.3 Third most frequently prescribed drug combinations for the treatment of Hypertension
- Figure 18.1 Mean percentage of patients prescribed different combined drug formulations for the treatment of Hypertension.
- Figure 18.2 Percentage of patients who receive the combined drug formulation clonidine/chlorthalidone for the treatment of Hypertension
- Figure 18.3 Percentage of patients who receive the combined drug formulation captopril/HCTZ for the treatment of Hypertension
- Figure 18.4 Percentage of patients who receive the combined drug formulation spironolactone/HCTZ for the treatment of Hypertension
- Figure 18.5 Percentage of patients who receive the combined drug formulation triamterene/HCTZ for the treatment of Hypertension
- Figure 18.6 Percentage of patients who receive the combined drug formulation valsartan/HCTZ for the treatment of Hypertension
- Figure 18.7 Percentage of patients who receive the combined drug formulation amlodipine/atorvastatin for the treatment of Hypertension
- Figure 18.8 Percentage of patients who receive the combined drug formulation telmisartan/HCTZ for the treatment of Hypertension
- Figure 18.9 Percentage of patients who receive the combined drug formulation irbersartan/HCTZ for the treatment of Hypertension
- Figure 18.10 Percentage of patients who receive the combined drug formulation trandolapril/verapamil for the treatment of Hypertension
- Figure 18.11 Percentage of patients who receive the combined drug formulation enalapril/HCTZ for the treatment of Hypertension
- Figure 18.12 Percentage of patients who receive the combined drug formulation amlodipine/valsartan for the treatment of Hypertension
- Figure 18.13 Percentage of patients who receive the combined drug formulation olmesartan/amlodipine for the treatment of Hypertension
- Figure 18.14 Percentage of patients who receive the combined drug formulation aliskiren/HCTZ for the treatment of Hypertension
- Figure 18.15 Percentage of patients who receive the combined drug formulation amlodipine/benazepril for the treatment of Hypertension
- Figure 18.16 Percentage of patients who receive the combined drug formulation Olmesartan Medoxomil/HCTZ for the treatment of Hypertension
- Figure 18.17 Percentage of patients who receive the combined drug formulation losartan/HCTZ for the treatment of Hypertension
- Figure 18.18 Percentage of patients who receive the combined drug formulation perindopril/amlodipine for the treatment of Hypertension
- Figure 18.19 Percentage of patients who receive the combined drug formulation delapril/manidipine for the treatment of Hypertension
- Figure 18.20 Percentage of patients who receive the combined drug formulation lercanidipine/enalapril for the treatment of Hypertension
- Figure 18.21 Percentage of patients who receive the combined drug formulation lisinopril/amlodipine for the treatment of Hypertension
- Figure 18.22 Percentage of patients who receive other combined drug Formulations for the treatment of Hypertension
Tables
- Table 3.1 Participant Countries
- Table 4.1 Mean percentage of patients diagnosed with different Hypertension subtypes
- Table 4.2 Other types of secondary Hypertension reported in this study
- Table 6.1 Mean percentage of patients prescribed different drug classes for the treatment of Hypertension.
- Table 7.1 Mean percentage of patients prescribed different diuretics for the treatment of
- Table 8.1 Mean percentage of patients receiving the top nine beta or alpha blockers for the treatment of Hypertension.
- Table 9.1 Percentage of patients receiving adrenergic receptor agonists for the treatment of Hypertension.
- Table 10.1 Mean percentage of patients receiving calcium channel blockers for the treatment of Hypertension.
- Table 11.1 Mean percentage of patients receiving ACE inhibitors for the treatment of Hypertension.
- Table 12.1 Mean percentage of patients receiving Angiotension II receptor Antagonists for the
- Table 13.1 Mean percentage of patients receiving statins for the treatment of Hypertension.
- Table 15.1 Mean percentage of patients receiving centrally acting drugs for the treatment of Hypertension.
- Table 17.1 Most frequently prescribed drug combinations for the treatment of Hypertension.
- Table 17.2 Second most frequently prescribed drug combinations for the treatment of Hypertension
- Table 17.3 Third most frequently prescribed drug combinations for the treatment of Hypertension.
- Table 18.1 Mean percentage of patients prescribed different combined drug formulations for the treatment of Hypertension.
- Table 19.1 Study participants
Appendix 1. Responses provided by study participants to the question: What are the major issues and challenges associated with the treatment of Hypertension? Responses given by physicians to this question (which in some cases may be brief, informal or abbreviated) are presented verbatim, except in those some cases where minor grammatical or typographical corrections have been made for reasons of clarity.
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