Antihypertensive drug prescription patterns and their impact on blood pressure outcomes in a tertiary care teaching hospital

Abstract

Background: The guidelines from the Joint National Committee (JNC-8) emphasize the importance of rapid blood pressure (BP) control to reduce morbidity and mortality. The success of hypertension treatment depends on various factors, with irrational prescription being strongly linked to poor BP control. This study aimed to evaluate the patterns of antihypertensive drug prescriptions among patients in a tertiary care teaching hospital. Methods: A hospital-based observational study was conducted in 2018, including all hypertensive patients on medication. Their prescription patterns were analyzed. Results: The study analyzed prescriptions from 240 hypertensive patients. The mean ages for male and female patients were 56.68±15.32 and 62.29±12.65 years, respectively. Physicians commonly prescribed monotherapy (34.60%) followed by two-drug (18.40%), three-drug (11.80%), and four-drug combinations (3.00%). The most frequent two-drug combination was ACE inhibitors + diuretics (4.40%), followed by angiotensin receptor blockers (ARBs) + diuretics (3.60%) and calcium channel blockers (CCBs) + ACE inhibitors (2.60%). Adherence to JNC 8 guidelines was 19.3% for pre-hypertension, 88.70% for stage 1 hypertension, and 73.29% for stage 2 hypertension. Conclusions: Monotherapies were the most commonly prescribed regimens. Twice-daily dosing and monthly appointments were associated with lower incidences of uncontrolled BP. However, complete adherence to standard guidelines was not observed in all cases, especially in patients with comorbid conditions.