Prescribing patterns of antihypertensive medications and blood pressure control among hypertensive patients in a primary care setting in Malaysia

Abstract

Aims: This study aims to describe the prescribing patterns of antihypertensive medications and short term outcomes of these patients, defined as repeat blood pressure measurements by a medical professional within 6 months, in a primary care facility in Puchong, located within the state of Selangor in Malaysia. Methods: This study was a cross-sectional, retrospective analysis of patients with essential hypertension, aged 18 and above, with blood pressure recorded at least twice within a 6-month period in an urban primary care clinic in Malaysia. Patients with history of co-morbidities were excluded. The prescribing patterns of antihypertensive medications and proportion of patients who achieved blood pressure control of less than 140/90 mmHg were ascertained. Results: A total of 200 prescriptions were analysed, including 52.5% females taking a mean of 1.7 (0.7) antihypertensive medications with a mean age of 57.9 (12.4) years. Most of the patients were prescribed either a single medication (n=90, 45.0%) or two medications (n=90; 45.0%) to control their blood pressure. Only 20 patients (10.0%) were prescribed three antihypertensive medications. A total of 127 (63.5%) patients met the blood pressure target of less than 140/90 mmHg. All participants exhibited a significant drop in systolic blood pressure, reducing from 143.0 (16.0) mmHg at baseline to 135.3 (14.8) mmHg at the end of 6 months (p<0.001). Diastolic blood pressure also decreased significantly from 83.5 (11.7) mmHg at baseline to 79.0 (10.2) mmHg at the end of 6 months (p<0.001). The choice of antihypertensive medications by the prescribers was compliant with the hypertension guidelines of Malaysia. Conclusion: The most commonly prescribed antihypertensive class was calcium channel blockers. Significant reduction in blood pressure was observed in patients from baseline to the follow-up visit. Further research of larger sample size and longer monitoring period is necessary to provide more robust epidemiology and drug utilisation data.