ANTIHYPERTENSIVE MEDICATION PRESCRIBING PATTERNS IN A UNIVERSITY TEACHING HOSPITAL IN SOUTH DELHI

ABSTRACT

Study objective: To investigate the use of antihypertensive drugs in hypertensive patients and to identify whether such pattern of prescription is appropriate in accordance with international guidelines for management of hypertension.

Methods: This was a prospective analysis. A prescription based survey among patients with established hypertension was conducted at the Medicine Out-Patient Department of University Teaching Hospital in South Delhi, India. Data were collected from patients’ medical records as well as patients’ interviews.

Results: A total of 192 hypertensive patients fulfilled the criteria for inclusion in the study analysis. Combination therapy was used more commonly than monotherapy (54.6% vs 45.4). Among the monotherapy category, the various classes of drugs used were as follows: beta- blockers (28.8%), diuretics (24.1%), calcium channel blockers (21.8%), ACE inhibitors (18.4%), angiotensin II receptor blockers (5.7%) and α 1- blocker (1.1%). With respect to overall utilization pattern, diuretics (42.2%) were the most frequently prescribed class, beta- blockers (41.2%) ranked second followed by calcium channel blockers (39.1%), ACE inhibitors (26.0%), angiotensin II receptor blockers (23.4%) and α 1- blocker (9.4%). As for individual medicines, amlodipine (35.4%) was the most commonly prescribed antihypertensive drug followed by atenolol (17.8%), ramipril (17.2 %) and furosemide (13.0 %). Among the combination therapies, 2- drug treatment was preferred for 75% of the hypertensive patients with CCB and β-blocker being the most frequent drug combination (22.4%).

Conclusion: The general pattern of antihypertensive utilization seems to be in accordance with the international guidelines for management of hypertension.