Hypertension control in communities (HCC): Analysis of antihypertensive drug regimen in baseline

Abstract

Objective: The project of Hypertension Control in Communities (HCC) aimed to determine the effect of community-based standardized management on control of hypertension. Analyzing the current pattern of antihypertensive drug regimen in baseline was helpful for focusing on the training key. Methods: The protocol of community-based standardized hypertension management was developed by an expert board being oriented by guidelines. Community health service centers across China were selected to implement the protocol. After being trained with the protocol, the grass-roots doctors from selected centers were asked to manage hypertensives in their communities according to the protocol. Patients who were serviced by the selected centers and with diagnosed hypertension were recruited. Data were collected by using questionnaire. Results: By the end of 2010, the program contained 255,168 patients with eligible baseline data, 93,953 (36.8%) of them under treatment with 47.7% male were used for this analysis. In baseline, patients with diuretic, β-blocker, CCB, ACEI, ARB, α-blocker and compound pill were 7.8%, 10.3%, 37.0%, 18.2%, 4.0%, 0.1%, 46.7%, respectively. In total, 84.1% patients took single antihypertensive drug in which 47.0% with compound pill and 28.8% with CCB; 16.6% were under combination drug therapy, out of them, 13.0% with two-drug, 2.6% with three-drug or more drugs. The used two-drug combinations are “CCB+ACEI” (38.0%), “β-blocker+CCB” (24.1%), and three-drug combinations are “β-blocker+CCB+ACEI” (15.8%), “diuretic+CCB+ACEI” (13.3%). Only 22.5% patients under treatment were controlled (<140/90 mmHg). Conclusion: The baseline status of medicine usage of HCC patients was subject to no standard in this article. It showed standardized management was necessary for the medicine usage and further improvement of hypertension control.