Drug utilization study of anti-hypertensive drugs and prescription pattern adherence with joint national committee-8 guideline


  • Karan M. Suthar Department of Pharmacology, AMC MET Medical College, Ahmedabad, Gujarat, India
  • Gurusharan H. Dumra Department of Pharmacology, AMC MET Medical College, Ahmedabad, Gujarat, India




JNC-8, Hypertension, Anti-hypertensive drugs, Prescription pattern, Adherence


Background: Hypertension is a major and serious non-communicable disease. It is also a major risk factor for cerebrovascular strokes, coronary artery thrombosis, and renal failure. The overall prevalence of hypertension in India is 29.8%. Joint national committee-8 guidelines on prevention, detection, evaluation, and treatment of high blood pressure highlight that aggressive blood pressure control is essential for the reduction of hypertension-associated morbidity and mortality.

Methods: It was a cross-sectional, observational study. Prescriptions were collected from four pharmacy stores located in four different areas of Ahmedabad over a period of 2 months. These were analysed along with relevant co-morbidities and, the level of prescription pattern adherence was assessed as per JNC 8 guidelines. Appropriate statistical tests were applied for analyses of collected data.

Results: A total of 321 prescriptions were collected. Out of them, 186(57.9%) were prescribed to male patients while 135 (42.1%) were for female patients. Mean systolic and diastolic blood pressure was found to be 152 mmHg and 91 mmHg respectively. The mean age of the patients was found to be 44.63 years. A total of 209 (65.1%), 91 (28.34%), 21 (6.54%) prescriptions had monotherapy, dual therapy, and polytherapy for treating hypertension respectively. Amlodipine (CCBs) was found to be the most commonly prescribed medicine as a monotherapy. The overall adherence rate was found to be 77.88%.

Conclusions: The present study demonstrated that medical professionals are not completely adhering to standard guidelines while prescribing antihypertensive drugs. There is substantial scope for improvement, particularly the utilization of antihypertensive agents in patients of the pre-hypertension category, where non-pharmacological measures play an important role to treat the condition.



Truter I. A review of drug utilization studies and methodologies. Jordan J Pharm Sci. 2010;1(2):91-104.

Sikidar P, Chakravarty P, Purkayastha A, Tigga R. A study on prescribing pattern of antihypertensives in adult patients attending in a tertiary care hospital of Assam, India. Int J basic Clin Pharmacol. 2016;5(3): 975-8.

Cushman WC. The Burden of Uncontrolled Hypertension: Morbidity and Mortality Associated With Disease Progression. J Clin Hypertens. 2003; 5(3):14-22.

Romday R, Gupta A, Bhambani P. An assessment of antihypertensive drug prescription patterns and adherence to joint national committee-8 hypertension treatment guidelines among hypertensive patients attending a tertiary care teaching hospital. Int J Res Med Sci. 2016;4(12):5125-33.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224-60.

Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: A systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hyper. 2014;32:1170-7.

Munger MA. Polypharmacy and combination therapy in the management of hypertension in elderly patients with co-morbid diabetes mellitus. Drugs Aging. 2010; 27:871-83.

Ginsberg G, Hattis D, Russ A, Sonawane B. Pharmacokinetic and pharmacodynamic factors that can affect sensitivity to neurotoxic sequelae in elderly individuals. Environ Health Perspect. 2009;32:1243-9.

Cooney D, Pascuzzi K. Polypharmacy in the elderly: focus on drug interactions and adherence in hypertension. Clin Geriatr Med; 2009;22:221-33.

Hansson L, Dahlöf B, Gudbrandsson T, Hellsing T, Kullman S, Kuylenstierna J, et al. Antihypertensive effect of felodipine or hydralazine when added to β-blocker therapy. J Cardiovasc Pharmacol. 2020;12(1): 94-101.

Kjeldsen SE, Farsang C, Sleigh P, Mancia G. 1999 who/ish hypertension guidelines - highlights & esh update. J Hypertens. 2001;19(12):151.

Ramsay LE, Williams B, Johnston GD, MacGregor GA, Poston L, Potter JF, et al. British Hypertension Society guidelines for hypertension management 1999: Summary. BMJ. 1999;630-5.

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;507-20.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. hypertens. 2003;32:1206-52.

Yhy Y, Liu C, Hu L. Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs. J Clin Pharm Ther. 1998;23(4):287-94.

Tiwari H, Kumar A. Prescription monitoring of anti-hypertensive drug utilisation at the Panjab University Health Centre in India. Citeseer. 2021.

Sakthi S, Thomas S, Sivakumar KK, Karhikeyan J, Saravana A. Antihypertensives. J Clin Pharm Ther. 1998;23(4):285-94.

Mateti UV, Konuru V, Parmar MY, Kunduru BR. A study on prescribing patterns of antihypertensives in geriatric patients. Perspect Clin Res. 2012;3(4):139.

Kaur S, Gupta S, Kumar D, Lal M. Prescribing pattern of antihypertensive drugs in a tertiary care hospital in Jammu-A Descriptive study. Perspect Clin Res. 2012; 17(4):38-41.

Liu C, Hu L. Prescribing pattern of antihypertensive drugs in a general hospital in central China. J Clin Pharm Ther. 1998;23(4):285-94.

AlDrabah E, Irshaid Y, Yasein N, Zmeili S. Prescription pattern of antihypertensive drugs in family practice clinics at Jordan University Hospital. Med Sci Int Med J. 2013;2(1):469.




How to Cite

Suthar, K. M., & Dumra, G. H. (2022). Drug utilization study of anti-hypertensive drugs and prescription pattern adherence with joint national committee-8 guideline. International Journal of Basic & Clinical Pharmacology, 11(3), 262–266. https://doi.org/10.18203/2319-2003.ijbcp20221042



Original Research Articles