Blood Pressure Control and Prescription Pattern of Antihypertensive Drugs in Adherence to the 2020 International Society of Hypertension (ISH) Global Hypertension Practice Guidelines in Saudi Arabia: A Retrospective Study

Abstract

BackgroundHypertension is the leading risk factor for cardiovascular disease and death. Appropriate treatment of hypertension is necessary to reduce mortality. A prescription-based study is one of the most influential and helpful methods to examine physicians' irrational prescribing practices. This study was designed to investigate the antihypertensive prescription of physicians and their adherence to the treatment guidelines, as well as the blood pressure (BP) control rate in a general hospital in the Kingdom of Saudi Arabia. MethodologyA retrospective, cross-sectional study was conducted between February 2020 and June 2021 in an outpatient department. Patients diagnosed with hypertension as per the 2020 International Society of Hypertension guidelines and those who received antihypertensive drugs were included. Study data included prescriptions, patient's age, duration of hypertension, comorbidities, BP, drug therapy type, and antihypertensive class. ResultsOverall, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (67.1%) were the most prescribed agents, followed by dihydropyridine-calcium channel blockers (62.6%), diuretics (26.1%), and βblockers (10.1%). Comorbid and stage 2 hypertensive patients mainly received combination therapy (51.6%) rather than monotherapy (48.4%). The study revealed an 83.5% prescription adherence to the treatment guidelines. However, non-adherence was encountered in monotherapy, polytherapy, and elderly-treated patient groups. A 66.4% (at target BP in all cases <140/90 mmHg) and 39.3% (at target BP in comorbid patients <130/80 mmHg) rate of BP control was observed. Furthermore, the rate of BP control was significantly associated with prescription adherence (χ 2 = 71.316; p < 0.001). ConclusionsThe degree of prescription adherence and rate of BP control were found to be compatible with other published hypertension studies. However, considerable scope exists for improvement in rational drug utilization and rate of BP control, particularly in high-risk patients. Therefore, treatment guidelines must be followed by clinicians to achieve BP goals and reduce cardiovascular events among the Saudi population.

Assessment of the Post-Marketing “Drug Ineffective” Reports Received by the Saudi Vigilance System

“…These findings correlate with the adult age group that was frequently associated with the reported DI in the current study, and align with the documented high prevalence of chronic diseases e.g. hypertension [26], diabetes [27] and hypercholesterolemia [28] among adults in the Kingdome of Saudi Arabia.…”

Potential Role of the Skin in Hypertension Risk Through Water Conservation

“…A plethora of basic and clinical studies have established that persistent hypertension, or chronically high blood pressure, represents a significant risk factor for cerebrovascular, cardiovascular, and renal disease. [1][2][3][4][5][6] The development of various antihypertensive medications and their efficacy for blood pressure control have contributed to a prolongation of healthy life expectancy. 1,2,[4][5][6] Moreover, numerous basic science studies of models of hypertension and genetically modified animals have shed light on some of the mechanisms involved in the development of hypertension, which include genetic factors, impaired renal and vascular function, and abnormal neural activity.…”

“…[1][2][3][4][5][6] The development of various antihypertensive medications and their efficacy for blood pressure control have contributed to a prolongation of healthy life expectancy. 1,2,[4][5][6] Moreover, numerous basic science studies of models of hypertension and genetically modified animals have shed light on some of the mechanisms involved in the development of hypertension, which include genetic factors, impaired renal and vascular function, and abnormal neural activity. [7][8][9] However, despite these advances, the pathogenesis of primary hypertension has not been fully elucidated.…”