713 BLOOD PRESSURE CONTROL AND THE NUMBER OF ANTI-HYPERTENSIVE DRUGS NEEDED AT AN URBAN PRIMARY CARE CLINIC

Abstract

Objectives: This study aims to examine the number of anti-hypertensive drugs needed to treat blood pressure to target over a 10-year period. Methods: Data was obtained from a 10-year retrospective cohort of randomly selected adult hypertensive patients registered with the Department of Primary Care Medicine Clinic at the University of Malaya Medical Centre. Demographic data, blood pressure (BP) and anti-hypertensive drug use in 1998, 2002 and 2007 were captured from the patients’ record. Target BP was defined as <140/90 mmHg for non-diabetics and <130/80 mmHg for diabetics. Results: 886 hypertensives were included in the study. Mean age in 1998 was 56.2 years and 34.7% were males. Mean BP in 1998 and 2007 was 146.0/87.8mmHg and 136/79.5mmHg respectively. Table I shows the number of anti-hypertensive drug used in 1998 and 2007. There was a substantial increase in the use of both two and three drugs and fewer were on monotherapy 10 years later. 24.1% (135/886) and 39.8% (353/886) of hypertensives achieved target BP control in 1998 and 2007 respectively. In 1998, an average of 1.2 drugs was needed to achieve target BP where 80.7% were on 1 drug and 17.0% on 2 agents. In 2007, those who achieved target BP needed a mean of 1.99 drugs with 22.9% being on 1 drug and 52.7% on 2 agents.Conclusion: There is an increase in the number of drugs needed to achieve target BP over a 10 year period. In order to achieve target BP more than 2 antihypertensive agents will be needed.