Prescription Pattern of Anti-Hypertensive Drugs in a Tertiary Health Institution in Nigeria

Abstract

Objective: This study examined the pattern of physicians\u2019 prescription of antihypertensive drugs and its possible effects on blood pressure control as well as physicians\u2019 compliance with recommended guidelines. Methods: Records of 145 patients aged 17-91 (mean: 52.6\ub114.6) years, with male to female ratio of 1:1.2 were randomly selected. Information on antihypertensive prescriptions was recorded. Blood pressure control was defined as systolic and diastolic blood pressure less than 140 mm Hg and 90mmHg, respectively. Results: Of the 145 patients studied, 20% (29) were on monotherapy and 80% (116) on combination therapy. Of the patients on combination therapy, 61.2% (71), 33.6% (39) and 5.2% (6) were on 2, 3 and 4 drugs, respectively. Diuretic was the most frequently prescribed drug either as a single agent (44.8%) or as combination therapy (88.8%). Mean reductions in both systolic and diastolic blood pressures were more in patients on calcium channel blocker than those on diuretic monotherapy (t=2.5 and 3.6 for reductions in systolic and diastolic BP, respectively; P<.05 for both), and, in patients on combination therapy than those on monotherapy (t=3.64 and 3.27 for reductions in systolic and diastolic BP, respectively; P<.01 for both). Blood pressure control rate was 30.5%. Conclusion: Our results are consistent with the previously observed benefits of antihypertensive combination therapy, and demonstrate an apparent higher efficacy of calcium channel blocker monotherapy than diuretic monotherapy in blood pressure lowering in the study population. Major limitations of this work include its retrospective nature and the inability to determine the actual patients\u2019 adherence to therapy.Objectif: Cette \ue9tude a examin\ue9 le sch\ue9ma de l\u2019ordonance m\ue9dicale (prescription m\ue9dicamenteuse) des antihypertenseurs et son effet possible dans le contr\uf4le de l\u2019hypertension art\ue9rielle ainsi que sa comformit\ue9 aux indications recommend\ue9es. Methode: Les donn\ue9es de 145 patients \ue2g\ue9s de 17 \ue0 91 ans, (moyenne: 52, 6+ 14, 6) avec un rapport d\u2019un homme pour 1, 2 femmes, ont \ue9t\ue9 recueillis au hazard. Des informations sur les ordonnances des antihypertenseurs ont \ue9t\ue9 enregistr\ue9es. Moins de 140mm/hg pour systolique et 90mm/hg pour diastolique ont \ue9t\ue9 retenus comme le contr\uf4le. Resultats: De 145 partients \ue9tudes, 20% soit patients \ue9taient sur le r\ue9gime monoth\ue9rapie (combin\ue9e). Pour les patient en r\ue9gime multith\ue9rapie, 61, 2% soit 71, 33, 6% soit 39 et 5, 2% soit 6 \ue9taient sur 2, 3, et 4 m\ue9dicaments respectivement. Les diur\ue9tiques \ue9taient plus fr\ue9quemment prescript, soit seuls (44, 8%) ou en combinaison avec d\u2019autres agents antihypertenseurs. La r\ue9duction moyenne dans les deux cas de systolique et diastolique \ue9tait plus \ue9lev\ue9e chez les patients prenant les diur\ue9tiques tout court. (= 2.5 et, 3.6 pour la r\ue9duction en systolique et diastolique respectirement; p<0.05 pour les deux cas), et chez les patients en th\ue9rapie combin\ue9e que chez ceux en monoth\ue9rapie (t = 3,64 et 3, 27 pour la r\ue9duction en systolique et diastolique respectivement; p< 0.01) pour les deux cas_. Le taux de contr\uf4le \ue9tait 30, 5%. Conclusion: Nos r\ue9sultats correspondent aux b\ue9n\ue9fices d\ue9j\ue0 observ\ue9s dans le r\ue9gime de la th\ue9rapie antihypertensive combin\ue9e, et montre une efficacit\ue9 clairement \ue9lev\ue9e de beta-bloquants de calcium (la chaine de bloquants de calcium) utilis\ue9s en monoth\ue9rapie que les diur\ue9tiques utilis\ue9s en monoth\ue9rapie dans l\u2019abaissement de la tension art\ue9rielle au sein de l\u2019\ue9chantillon de l\u2019\ue9tude