Study of Antihypertensive Use in Elderly Subjects with or Without Comorbid Conditions in A Tertiary Care Hospital

Abstract

Hypertension is the commonest cardiovascular disorder, with the prevalence progressively increasing with age and elderly subjects are more prone for various hypertension-related complications. Presence of various co-morbid conditions influences the choice and dose of antihypertensive medications. Persistent adherence to the prescribed medications and lifestyle measures are very essential to reduce the morbidity and mortality, and to improve the QOL. The objective of the study is to determine the pattern of antihypertensive prescribing, to assess the medication compliance and Quality of life. 250 elderly hypertensive subjects of either gender were recruited in to the present study to assess the prescribing pattern of antihypertensives; details of drug therapy, therapeutic class, dose, route, frequency, duration of administration. The compliance was 8-item questionnaire as per Morisky Medication Adherence Scale and the Quality of life was assessed using MINICHAL Instrument, consisting of 17-item questionnaire. The most commonly prescribed antihypertensives were angiotensin receptor blockers (55%) and calcium channel blockers (55%) and, angiotensin receptor blocker + thiazide diuretic combination was the commonest dual antihypertensive therapy prescribed. 41.2% subjects had good level of medication compliance, 48.4% subjects had moderate level of compliance and 10.4 % subjects had poor level of compliance. The mean total scores of the HRQoL scale in the subjects with pre hypertension was 26.20±8.01, 25.66±9.38 in subjects with stage 1 HTN and 29.36±8.66 in subjects with stage 2 HTN. The most common antihypertensives were angiotensin receptor blockers and calcium channel blockers. The level of compliance was influenced by factors such as age, gender, co morbidities, severity of hypertension and number of medications. HRQoL of the study population was influenced by severity of hypertension.