Physician and Patient Preferences for Sustained Release Antihypertensive Preparations in the Kumasi Metropolis; Ghana

Background: Non-adherence to therapy is a major reason for the low control rate of hypertension in Ghana today. Sustained release (SR) antihypertensive preparations are useful in promoting adherence to therapy because of the reduced daily dosing frequency; stable drug levels and reduced toxicity which enhances compliance. One major concern about SR antihypertensives is whether they can be substituted with one another to produce the same effect. Objectives: This study sought to determine the preferences of physicians and patients for various SR antihypertensive medications in the Kumasi metropolis of Ghana. The views of the respondents on whether the brands of the most used SR antihypertensive were therapeutically equivalent and interchangeable were ascertained. Methods: Seventy-three (73) community pharmacies; 66 doctors and 150 patients in 50 public; private and mission hospitals and clinics within the Kumasi metropolis were purposively sampled. Respondents were interviewed via interviewer administered structured questionnaires and the information gathered was coded; entered into SPSS software version (16) and analysed. The results were presented as frequencies and proportions; and in tables as well as in figures.Results: SR nifedipine was the most stocked and used SR antihypertensive drug while Nifecard XL (30 mg) was the preferred brand of patients and doctors. Clinicians considered effectiveness and compliance as two major reasons for their preference for SR nifedipine while patients considered affordability and availability. Sixty percent of prescribers and 41% of patients were of the opinion that all brands of SR nifedipine were interchangeable. Conclusion: There is a gap between prescribers and patients about SR nifedipine brands interchangeability which needs to be bridged to optimize their use to attain better treatment outcomes in Ghana. There is need for continuous education on concepts of therapeutic equivalence and generics substitution for all stakeholders to address the problem of non-adherence to hypertension therapy in Ghana

Etude sur l'efficacite de la Nifedipine dans le traitement de l'hpertension arterielle

L'hypertension arterielle est une affection grave. Elle merite d'etre rapidement traitee afin d'eviter ses complications souvent graves. L'auteur propose integralement une etude faite sur l'efficacite de la Nifedipine dans le traitement de l'hypertension arterielle

A comparative study of isradipine and nifedipine in the monotherapy of mild to moderate hypertension in the Ghanaian

Clinical experience with the new dihydropyridine calcium antagonist; isradipine; is reported. Isradipine was compared with nifedipine in a multicentre open; parallel group; clinical therapeutic trial involving 70 patients with mild to moderate hypertension. A four week placebo washout period was followed by a 12 week active treatment period during which patients were randomized to receive either 2.5mg isradipine twice daily (n=40) or 10mg nifedipine three times daily (n=30). Isradipine significantly reduced sitting systolic/diastolic blood pressures from 176.7+/-21.0/106.7+/-7.0mmHg to 142.9+/-15/93.1+/-7.7mmHg (p0.001) at the end of 12 weeks. Similarly; nifedipine reduced sitting systolic/diastolic blood pressures from 170.1+/-19.5/106.2+/-7.4mmHg to 139.1+/-9.7/92.1+/-7.8mmHg (p0.001). Normalisation (diastolic 90mmHg) rates were 67 per cent and 60 per cent for isradipine and nifedipine respectively while good response (diastolic fall 10mmHg) rate was over 85 per cent on either drug. Heart rate did not significantly change with either treatment. Three (3) patients taking isradipine experienced headache and 7 patients taking nifedipine had drug related adverse effects (5 had headache; 1 insomnia and 1 first dose hypotension). Therapy was withdrawn in 4 patients taking nifedipine and 1 taking isradipine. It is concluded that isradipine is comparable to nifedipine and is an effective and well tolerated antihypertensive agent in the Ghanaian

A study of the effect of nifedipine in reversing left ventricular hypertrophy in hypertensive patients

Using WHO hypertensive criteria; 184 patients with hypertension were chosen (102 male; 82 female); aged 58-78 years old. Other heart diseases were ruled out by physical examination; electrocardiographic examination; chest-ray and echocardiography. All the cases had one or more criteria of left ventricular hypertrophy (LVH): Interventricular septal thickness at diastole; left ventricular posterior wall thickness at end diastole and left ventricular mass index. The findings in this study imply that it is good practise to include nifedipine in the treatment regimen of patients whose hypertension is complicated with LVH and (or) ischaemic heart disease