Abstract
The main objective of the present study to investigate the utilization pattern of antihypertensive drugs in hypertensive patients and to find out whether the prescription pattern is in adherence with the JNC7 guidelines for the management of hypertension. A prospective study was conducted and drug utilization data were collected from 137 hypertensive patients who were attended as Out Patient Department (OPD) of Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, Bihar, India. The data was retrieved from patientâs medical records as well as from the interview of patients and their legally acceptable representatives. The following classes of antihypertensive drugs were analyzed; Angiotensin Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARBs), Beta Blockers (BBs), Calcium Channel Blockers (CCBs) and Diuretics. The inclusion criteria for the recruitment of study subjects were the patients suffering from hypertension with or without other co-morbid conditions. The analysis of the prescription frequency, proportion of the different antihypertensive classes of drugs as monotherapy as well as combination therapy was done. The most frequently prescribed classes of antihypertensive medications were Diuretics (mainly thiazides followed by Loop category) followed by CCBs, BBs, ACEIs and ARBs. Antihypertensive drug combination therapy was given to 72.26% of the total population while monotherapy was received by 27.73% of the total hypertensive population, representing more utilization of combination therapy as compared to monotherapy. The prescription pattern of these classes of drugs was found to be considerately in adherence to JNC7 guidelines for the management of hypertension. It was evident from the study that hypertension is more pronounced in males with increasing age as compared to females. The diuretics were the first choice alone or in combination and pattern of prescription was adhered to JNC-7 Guidelines.
Highlights
Worldwide the estimates for prevalence of hypertension, to a large extent as 1 billion individuals and approximately around 7.1 million deaths per year may be attributable to hypertension (JNC 7, 2003)
Data from the National Health and Nutrition Examination Survey (NHANES) has suggested that 50 million or more Americans are suffering from high Blood Pressure (BP) demanding some form of treatment (Burt et al, 1995; JAMA, 1997)
The prescription data was obtained from the Out Patient Department (OPD) of Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), a research hospital in Patna, (Bihar), North India
Summary
Worldwide the estimates for prevalence of hypertension, to a large extent as 1 billion individuals and approximately around 7.1 million deaths per year may be attributable to hypertension (JNC 7, 2003). Hypertension is one of the leading contributing factor to many other diseases including Myocardial Infarction (MI), stroke, heart failure, renal failure and retinopathy, a leading cause of death . The report of World Health Organization 2002 states that high blood pressure is the primary or may be secondary cause in some cases for 50% of cardiovascular diseases and subsequent deaths worldwide (Guilbert, 2003). The purpose of JNC 7 report guidelines is to amalgamated the available scientific evidences and offer guidance to burdened primary care Clinicians
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