ABSTRACT
Background: Hypertension is a major non-communicable disease and a large proportion of patients are not treated adequately even though several antihypertensive drugs and various guidelines are available. Aims and Objectives: The aim of the study was to study the treatment pattern and effectiveness of the antihypertensive drugs by estimating the blood pressure (BP) control achieved based on Joint National Committee (JNC) 8 guidelines for the treatment of hypertension. Materials and Methods: In this observational study, 92 patients with primary hypertension diagnosed since 1 1/2 years were included in the study. BP at the time of diagnosis and on subsequent follow-up visits and details of antihypertensive drugs prescribed during each visit were recorded, until target BP was achieved or till the end of the study period. Wilcoxon Signed Rank test and Mann–Whitney U test were used for analyzing the dependent and independent groups, respectively. Results: Mean age of patients was 57.50 years and 54.3% of them were females. Majority received single drug (80.43%) compared to combination therapy (19.57%). Most frequently prescribed antihypertensive drug group was angiotensin receptor blockers (47.75%) followed by calcium channel blockers (41.44%) and most commonly prescribed individual drugs were losartan and amlodipine (both 25.22%). Seventy-three (79.30%) patients attained their target BP and the average time taken for the adequate control of BP was 5.67 (S.D ± 2.674) weeks. Conclusion: JNC 8 guidelines were found to be effective in this study population.
ABSTRACT
Introduction: The increasing prevalence of hypertension isattributed to population growth, ageing and behavioural riskfactors, such as unhealthy diet, harmful use of alcohol, lackof physical activity, excess weight and exposure to persistentstress. The present study was conducted to study on variousfacets of antihypertensive drugs prescribing at present scenarioat Dr B.C. Roy Hospital, Haldia, and with objectives of studyingprescribing patterns and rationality of antihypertensive drugsin essential hypertension with or without specific co-morbidconditions and to check compliance of treatment as per JNC-8hypertension treatment guidelines in the outpatients attendingthe Department of Medicine.Material and Methods: Data regarding anti-HTN monotherapy and combination therapy was recorded. Evaluation forrational drug therapy by evaluating average number of drugsper prescription, fixed dose combination (FDC) prescriptionrate, prescription laying down importance of lifestylemanagement, prescription with defined anti-HTN goals,prescriptions with correct dose strength and dosage schedulewas evaluated.Results: Out of 100 hypertensive patients under evaluation 67was males (67%) with a M:F ratio of 2.03:1. Mean SBP wasslightly higher in male patients. Hypertension was classifiedaccording to JNC-8 guidelines and found 22 (22%) (Prehypertension/pre-HTN), 57 (57%) (Stage 1 hypertension),and 13% (stage 2 hypertension) cases. Dyslipidemia wasnoted much more common associated disorders among newlydiagnosed hypertensive of either sex.Conclusion: Diuretics (8%) were most widely prescribeddrugs followed by ARBs (6%), ACE Inhibitors (5%) andcalcium channel blockers (4%) as monotherapy. Adherence ofJNC 8 guidelines among all study hypertensive participantswhile prescribing medications varied between 62% to 92%,with an average of 75%. None of the prescriptions mentionedban drug formulation(s). Still 15% of the prescriptionshad suggested combined drugs with debated rationalityformulations.
ABSTRACT
Background: Hypertension (HTN) is one of the most common diagnoses in a primary health care setting and it is one of the important and preventable contributors to disease and death. HTN is considered as an additional risk factor in anesthesia and HTN is of special importance to the anesthetist for various reasons. Tracheal intubation, surgical incision, recovery from anesthesia, and post-operative pain can increase blood pressure (BP). Objectives: This study aims to find out the burden of pre-operative HTN and its risk factors among patients who were admitted for surgical procedures at a tertiary health care facility of Durgapur, West Bengal, India. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, an institution based, observational, and cross-sectional study was conducted from January 2019 to February 2019. A pre-tested, semi-structured schedule was used to collect Clinic Social data. Anthropometric measurements and BP were taken as per the world health organization STEP-wise approach to surveillance guidelines. BP was classified as per “The eighth joint national committee (JNC-8) guidelines. Results: Data were collected from 150 study subjects and were analyzed using SPSS, version 20.0 for windows. The frequency of pre-operative HTN and pre-HTN was found to be 38.0% and 32.0% respectively. As per JNC-8, 34.7% had Stage-1 HTN followed by 32.0% and 3.3% who had pre-HTN and Stage-2 HTN, respectively. Increasing age, male gender, smoking, increasing body mass index, dyslipidemia, and Type 2 diabetes mellitus (T2DM) were significantly associated with a higher frequency of HTN. Conclusion: There is a very high prevalence of pre-operative HTN and pre-HTN. Increasing age, male gender, smoking, overweight, obesity, dyslipidemia, and T2DM were significant risk factors for HTN. Routine screening of HTN should be done in surgical ward to see if there are cases of “white coat” HTN.