Prescription Pattern of Anti-Hypertensive Drugs in Adherence to JNC- 7 Guidelines

Abstract

The main objective of the present study to investigate the utilization pattern of antihypertensive drugs in hypertensive patients and to find out whether the prescription pattern is in adherence with the JNC7 guidelines for the management of hypertension. A prospective study was conducted and drug utilization data were collected from 137 hypertensive patients who were attended as Out Patient Department (OPD) of Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna, Bihar, India. The data was retrieved from patient’s medical records as well as from the interview of patients and their legally acceptable representatives. The following classes of antihypertensive drugs were analyzed; Angiotensin Converting Enzyme Inhibitors (ACEI), Angiotensin Receptor Blockers (ARBs), Beta Blockers (BBs), Calcium Channel Blockers (CCBs) and Diuretics. The inclusion criteria for the recruitment of study subjects were the patients suffering from hypertension with or without other co-morbid conditions. The analysis of the prescription frequency, proportion of the different antihypertensive classes of drugs as monotherapy as well as combination therapy was done. The most frequently prescribed classes of antihypertensive medications were Diuretics (mainly thiazides followed by Loop category) followed by CCBs, BBs, ACEIs and ARBs. Antihypertensive drug combination therapy was given to 72.26% of the total population while monotherapy was received by 27.73% of the total hypertensive population, representing more utilization of combination therapy as compared to monotherapy. The prescription pattern of these classes of drugs was found to be considerately in adherence to JNC7 guidelines for the management of hypertension. It was evident from the study that hypertension is more pronounced in males with increasing age as compared to females. The diuretics were the first choice alone or in combination and pattern of prescription was adhered to JNC-7 Guidelines.