1 research outputs found
Brief Report - Extent of Use of Immediate-Release Formulations of Calcium Channel Blockers as Antihypertensive Monotherapy by Primary Care Physicians: Multicentric Study from Bahrain
Background: The issue of cardiovascular safety of calcium channel
blockers (CCBs) has been widely debated in view of reflex increase in
sympathetic activity induced by immediate release (IR) / short acting
formulations. It is generally agreed that such CCBs should not be used
alone in the management of hypertension. Aims: We have determined the
extent to which primary care physicians prescribe CCBs as monotherapy,
especially the immediate release formulations, in the management of
uncomplicated hypertension and diabetic hypertension - with an emphasis
upon the age of the patients. Setting, Design and Methods: A
retrospective prescription-based study was carried out in seven out of
18 Health Centres in Bahrain. The study involved a registered
population of 229,300 representing 46% of registered individuals, and
35 physicians representing 43% of all primary care physicians. The data
was collected between November 1998 and January 1999 using chronic
dispensing cards. Results: In all categories CCBs were the third
commonly prescribed antihypertensive as monotherapy, with a
prescription rate of 11.1% in uncomplicated hypertension, 18% in
diabetic hypertension and 20.1% in elderly patients above 65 years of
age. Nifedipine formulations were the most extensively prescribed CCBs.
Almost half of the CCB-treated patients were on IR-nifedipine, whereas
IR-diltiazem and IR-verapamil, and amlodipine were infrequently
prescribed. Conclusion: Prescription of IR-formulations of CCBs as
monotherapy by primary care physicians does not conform with
recommended guidelines. In view of concerns about the safety of such
practice, measures to change the prescribing pattern are required