Published: 2019-12-24

Pattern of use of anti-hypertensive drugs amongst hypertensive patients in a tertiary care hospital: a cross sectional, observational study

Sharmin Khan, Ram N. Maiti, Sekhar Mandal


Background: Hypertension is one of the primary modifiable risk factors for cardiac and renal diseases and is the single most important risk factor for stroke. Despite different guidelines for management of hypertension like Joint National Committee, British Hypertension Society, National Institute for Health and Care Excellence; there are still the clouds of controversy. The objective of the study was to evaluate the prescribing pattern of antihypertensive drugs among the patients attending medicine outpatient department of a tertiary care teaching hospital

Methods: A cross-sectional, observational study was conducted in our hospital over a period of six months. Relevant information was collected from medical records of 209 hypertensive patients fulfilling inclusion criteria. The collected data were sorted and analyzed.

Results: Out of 209 patients, maximum were of age group of 45-65 years (55.02%). 115 (55.02%) were male and 94 (44.97%) were female. Diabetes mellitus (24.4%) was the most common associated disease with hypertension. Most of the patients had received single antihypertensive drugs (49.28%). Among the monotherapy category calcium channel blocker (82.78%) was the most commonly prescribed antihypertensive drug class followed by angiotensin receptor blocker (36.36%). Amlodipine (81.82%) was the most common among calcium channel blockers. The most frequent fixed drug combination prescribed consisted of amlodipine and atenolol. Most of the drugs were prescribed in generic name (90.9%).

Conclusions: The treatment pattern, in general, conformed to standard treatment guidelines.


Hypertension, Amlodipine, Generic

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Andreadis EA. Hypertension and cardiovascular disease. Springer; 2016: 1-17.

High Blood Pressure: the largest epidemic known to mankind. Available at: Accessed on 4 May 2017.

NCD Risk Factor collaboration (NCD-Rise). Lancet. 2017;386(10064):37-55.

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903-13.

New approaches to managing dyslipedemia: Risk Reduction Beyond LDL-C. Available at: http://www. Accessed on 4 May 2017.

Rosendorff C, Black HR, Cannon CP, Gersh BJ, Gore J, Izzo JL Jr, et al. Treatment of hypertension in the prevention and management of ischemic heart disease. Circulation. 2007;115:2761-88.

Mandal S, Maiti T, Das AK, Das A, Mandal A, Sarkar BS, et al. Drug utilization study in patients with type 2 diabetes mellitus attending diabetes clinic of a tertiary care hospital in rural Bengal. Int J Basic Clin Pharmacol. 2016;5(4):1647-54.

Rachana PR, Anuradha HV, Shivamurthy MC. Anti Hypertensive Prescribing Patterns and Cost Analysis for Primary Hypertension: A Retrospective Study. J Clin Diagn Res. 2014;8(9):19-22.

Xavier D, Noby M, Pradeep J, Pais P. Pattern of drug use in hypertension in a tertiary hospital: A cross sectional study in the in-patient wards. IJP. 2001;33:456-7.

Beg MA, Dutta S, Varma A, Kant R, Bawa S, Anjoom M, et al. Study on drug prescribing pattern in hypertensive patients in a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Med Sci Public Health. 2014;3:922-6.

Tiwari H, Kumar A, Kulkarni SK. Prescription monitoring of anti-hypertensive drug utilisation at the Punjab University Health Centre in India. Singapore Med J. 2004;45:117-20.

Pai PG, Shenoy J, Sanji N. Prescribing patterns of antihypertensive drugs in a South Indian tertiary care hospital. Drug Invention Today. 2011;3:38-40.

Etuk E, Isezuo SA, Chika A, AkucheJ, Ali M. Prescription pattern of anti-hypertensive drugs in a tertiary health institution in Nigeria. Ann Afr Med. 2008;7:128-32.

Sakthi S, Thomas S, Sivakumar KK, Karhikeyan J, Saravana kumar N. Assessment of anti hypertensive prescribing pattern and patient counseling in an urban population. Der Pharmacia Lettre. 2010;2:156-63.

Mancia G, Backer GD, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC Task Force on the management of arterial hypertension. Eur Heart J. 2007;28:1462-536.

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. 2003: 1-86.

Sandozi T, Emani VK. Survey of prescription pattern of anti-hypertensive drugs in hypertensives and hypertension associated diabetics. Int J Pharm Bio Sci. 2010;1:23-6.

Solanki KC, Mistry RA, Singh AP, Jadav SP, Patel NM, Trivedi HR. Drug utilization study of anti- hypertensive drugs and their adverse effects in patients of a tertiary care hospital. J Clin Exp Res. 2013;1:58-67.

Jhaj R, Goel NK, Gautam CS, Hota D, Sangeeta B, Sood A, et al. Prescribing patterns and cost of antihypertensive drugs in an internal medicine clinic. Indian Heart J. 2001;53:323-7.

Catic T, Begovic B. Outpatient antihypertensive drug utilization in Canton Sarajevo during ve years period (2004-2008) and adherence to treatment guidelines assessment. Bosn J Basic Med Sci. 2011;11:97-102.

Frattola A, Parati G, Cuspidi C, Albini F, Mancia G. Prognostic value of 24-hour blood pressure variability. J Hypertens. 1993;11:1133-7.

Bakris G. Are there effects of renin-angiotensin system antagonists beyond blood pressure control? Am J Cardiol. 2010;105:21-9.

Datta S. Utilization Study of Antihypertensives in a South Indian Tertiary Care Teaching Hospital and Adherence to Standard Treatment Guidelines. J Basic Clin Pharma. 2017;8:33-7.

Khurshid F, Aqil M, Alam MS, Kapur P, Pillai KK. Monitoring of adverse drug reactions associated with antihypertensive medicines at a university teaching hospital in New Delhi. Daru. 2012;20:34.

Akici A, Kalaca S, Ugurlu U, Hale Z. Toklu, Oktay S. Antihypertensive drug utilization at health centres in a district of Istanbul. Pharm World Sci. 2007;29:116-21

Quick JD, Hogerzeil HV, Velasquez G, Rago L. Twenty-five years of essential medicines. Bull World Health Organ. 2002;80:913-4.