DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20194264

A study on drug utilization pattern of antihypertensive drugs in hypertensive diabetic patients

Vikash Verma, Mukesh Kumar, Arvind Gupta, Kavita Dhar, Jyotshana Sharma

Abstract


Background: Hypertension management is of paramount importance in diabetic patients for reduction of cardiovascular and other complications. The objective of the present study was to assess prescribing pattern of antihypertensive drugs in hypertensive type 2 diabetic patients and evaluate them by comparing with Eighth Joint National Committee (JNC-8) hypertension treatment guidelines.

Methods: A prospective observational study was carried out on 110 hypertensive type 2 diabetic patients of age 41-80 years visiting outpatient department of Medicine at G.S. Medical College and Hospital, UP, India for 4 months. JNC-8 hypertension management guideline was considered while evaluating the prescribed drugs. All the relevant data was collected from the prescription card of the patient on a preformed performa and analyzed using descriptive statistics.

Results: Total of 176 drugs was prescribed to the study patients among which two drug combination therapy (55.45%) was mostly used. The most common group prescribed was angiotensin receptor blocker (ARB) (29.45%) and ARB+CCB (calcium channel blockers) (34.92%) were the commonest fixed drug combination. Overall, it was amlodipine (21.47%) that was most frequently prescribed among all antihypertensive drugs.

Conclusions: ARB was the most commonest class, ARB+CCB was the most frequent fixed drug combination prescribed to the study patient while amlodipine was the highly utilized individual antihypertensive drug in the study. Prescriptions evaluation revealed that 94.88% prescription were rational and were in accordance with the JNC-8 hypertension treatment guidelines except the use of beta blockers (5.12%).


Keywords


Hypertension, Type 2 diabetes mellitus, Antihypertensive drugs, Amlodipine, Telmisartan

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References


El-Hazmi MA, Warsy AS. Association of hypertension and non-insulin-dependent diabetes mellitusin the Saudi population. Ann Saudi Med. 2001;21(1-2):5-8.

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217-23

Venugopal K, Mohammed MZ. Prevalence of hypertension in type-2 diabetes mellitus. CHRISMED J Health Res. 2014;1(4):223-7.

Muntner P, Woodward M, Mann DM, Shimbo D, Michos ED, Blumenthal RS, et al. Comparison of the framingham heart study hypertension model with blood pressure alone in the prediction of risk of hypertension: the multi-ethnic study of atherosclerosis. Hypertens. 2010;55(6):1339-45.

Emdin CA, Rahimi K, Neal B, Callender T, Percovic V, PatelA. Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2015;313:603-15.

Fuller J, Stevens LK, Chaturvedi N, Holloway JF. Antihypertensive therapy for preventing cardiovascular complications in people with diabetes mellitus. Cochrane Database of Systematic Reviews. 2000;2:CD002188.

Bakris GL, Williams M, Dworkin L, Elliott WJ, Epstein M, Toto R, et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. Am J Kidney Dis. 2000;36(3):646-61.

Paul JA, Suzzane O, Carter BL, Cushman WC, Himmelfarb CD, 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;311(5):507-20.

Kjeldsen S, Feldman RD, Lisheng L, Mourad JJ, Chiang CE, Zhang W, et al. Updated national and international hypertension guidelines. Drugs. 2014;74(17):2033-51.

Shah J, Khakhkhar T, Bhirud S, Shah RB, Date S. Study of utilization pattern of anti-hypertensive drugs in hypertensive diabetic patients with or without reduced renal function at tertiary care teaching hospital. Int J Med Sci Public Health. 2013;2(2):175-80.

Anthony V. Screening for hypertension and lowering blood pressure for prevention of cardiovascular disease events. Med Clin North Am. 2017;101(4):701-12.

Mark N. Drug treatment of elevated blood Pressure. Aust Presr. 2010;33:108-12.

Feskens EJ, Kromhout D. Cardiovascular risk factors and the 25-year incidence of diabetes mellitus in middle-aged men. Am J Epidemiol. 1989;130(6):1101-8.

GarcĂ­a CG, Guerra AFR. Combination therapy in the treatment of hypertension. Drugs Context. 2018;7:212531.

Khrime D, Kumar A, Pandey AN, Bansal N, Sharma U, Varma A. Antihypertensive drug utilization pattern and awareness in diabetic hypertensive patients at tertiary care centre. Int J Res Med Sci. 2015;3(5):461-5.

Song L, Fang LZ, Chen JH. Utilization pattern of antihypertensive drugs in Chinese diabetics. Biomed Res. 2017;28(1):178-84.

Vila EH. A review of JNC-8 Blood pressure guidelines. Texas Heart Institute J. 2015;42(3):226-8.

Sica DA. Rationale for fixed drug combination for treatment of hypertension: the cycle repeats. Drugs. 2002;62(3):443-62.

Alavudeen SS, Alakhali KA, Ansari SMA, Abdulla N. Prescribing pattern of antihypertensive drugs in diabetic patients of Southern Province, Kingdom of Saudi Arabia. Ars Pharm. 2015;56(2):109-14.