Antihypertensive Drug Regimen for High Blood Pressure Associated with Modifiable Cardiovascular Risk Factors Among Hypertensive Patients Attending Campus Teaching Hospital of Lomé, Togo, West Africa

Abstract

Objective: The present prospective study was aimed to target the antihypertensive drug regimen for HBP associated with modifiable cardiovascular risk factors such as stressful and sedentary lifestyle, obesity, diabetes and chronic ethylism among hypertensive patients. Material and Method: This study was conducted among outpatients and inpatients attending the department of cardiology of Campus Teaching Hospital for hypertension conditions associated with comorbidities (stressful, sedentary lifestyle, obesity, diabetes and ethylism) and placed on antihypertensive drug therapy. Results: Of the 112 patients treated for HBP, 43 (38.39%) received an ambulatory treatment and 69 (61.61%) were hospitalized. Of 43 outpatients, 37.21% and 18.60% vs 24.64%, 34.78% and 23.19% of 69 inpatients presented respectively 2, 3 and ≥ 4 concomitant modifiable risk factors. Regarding the antihypertensive drug regimens received and concomitant risk factor profile of patients, significant reduction of Systolic Blood Pressure (SBP) among patients with 3 risk factors and Diastolic Blood Pressure (DBP) among patients with at least, together with chronic ethylism, another risk factor among stressful, sedentary lifestyle, obesity and diabetes, was observed. In cases of complicated HBP, outpatients with 3 concomitant risk factors against inpatients with high stress, sedentary lifestyle and obesity were placed on diuretic (D), Calcium Channel Antagonist (CCA) and Angiotensin Converting Enzyme Inhibitor (ACEI) as first choice in monotherapy or in addition to Centrally Acting Antihypertensive Drug (CAAD) in suitable combinations in 2/3 of total combinations prescribed. Conclusion: antihypertensive drug regimens from mono to quadruple therapy allowed to control significantly SBP in patients with 3 concomitant modifiable risk factors and DBP among patients with at least, together with chronic ethylism, another risk factor among stress, sedentarity, obesity and diabetes. In complicated HBP with concomitant modifiable risk factors, D or CCA or ACEI or in suitable combinations in addition to CAAD were the favorite pharmacological groups prescribed.