Drug prescription/blood pressure control in patients on monotherapy attending a tertiary hospital in Nigeria
Keywords:Hypertension, Drug utilization, Monotherapy, Nigeria
Background: Current treatment guidelines for treatment of hypertension stipulate the use of diuretics or calcium channel blockers (CCBs) as first-line treatment. Although, many studies have been carried out to study prescription pattern and blood pressure (BP) control in this region none has independently compared the effect of different antihypertensive drug classes given as monotherapy on BP control. This study compares the BP lowering efficacy of different classes of antihypertensive drugs given as monotherapy in black hypertensive patients with or without complications.
Methods: This prospective cross-sectional study evaluated the influence of antihypertensive prescription on BP controls among consecutive patients present on clinic days from November 2011 to April 2012. Patients were treated with either angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, beta-blocker, CCB, centrally acting adrenergic drug or diuretic. The primary outcome was BP reading <140/90 mmHg in patients without complication or <130/80 mmHg in patients with complication.
Results: Of 264 patients, 228 patients received one drug whereas 36 received no drug. More than half of those on non-pharmacological intervention had good BP control (n=21), patients on diuretic (28.8%) had a significantly higher BP control (p=0.014) than those on other classes of drugs. Only 58% of the patients had good BP control. Diastolic BP reduced with an increase in age.
Conclusions: Inthis study, diuretics significantly reduced BP compared with other antihypertensive class. Although clinical trials also suggest the use of CCB as first‑line treatment, cost considerations are necessary.
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