A study of pattern of various drugs used for treatment of hypertension at tertiary health care centre

Abstract               Background: The prevalence of hypertension has been increasing in India. The average prevalence of hypertension in India is 25% in urban and 10% in rural inhabitants Aims and Objectives: To Study the pattern of various drugs used for treatment of Hypertension at tertiary health care centre. Methodology: The Present study was undertaken by the department of Pharmacology in collaboration with the department of Medicine on newly diagnosed patients of Hypertension attending Medicine outpatient department of HKE society’s Basaveshwara Teaching and General hospital, attached to M.R. Medical College, Kalaburagi a for a period of 12 months from January 2017- December 2017. The statistics presented in the percentages and tabular form. Result:The mean age in the patients received Cilnidipinewas 42.98 ± 8.35 and Amlodipine was 44.48 ± 9.03.Out of total 100 patients, Male: Female ratio of 67:33 was found in the patients enrolled for our study. Both the groups had more patients with moderate elevation of blood pressure. In Cilnidipine group majority of the patients required concomitant drugs like–ARBsi.e. 54% followed by Diuretics34% , ACIs- 26%,Antidiabetics-14% etc. andin Amlodipine group the majority of the patients required ARBs- 50%,ACIs- 34% , Statins- 20%, Antidiabetics- 20%, β blockers-16%, Diuretics- 12% etc.Conclusion:It can be concluded from our study that In Cilnidipine group majority of the patients required concomitant drugs like–ARBs, Diuretics, ACIs, AntidiabeticsandinAmlodipine groupthe majority of the patients required ARBs, ACIs, Statins, Antidiabetics,β blockers,Diuretics etc.

Key Word: Hypertension, ARBs, Diuretics, ACIs, Antidiabetic, Amlodipine, Cilnidipine

INTRODUCTION

The definition of hypertension as released by the seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood. pressure (JNC 7) is systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mm Hg, which simplifies hypertension classification by including only stage I (SBP 140–159 mm Hg or DBP 90–99) or stage II (SBP 160 mm Hg or higher or DBP 100 mm Hg or higher). Perhaps the most important change is the new classification of “pre–hypertension” (SBP 120–139 mm Hg or DBP 80–89 mm Hg), which combines the normal and high normal categories of the previous JNC VI report, in the recognition of the fact that even these levels of BP confer an increased risk of the development of hypertension and future cardiovascular events^{1, 2} Many risk factors may contribute to its development, including age, gender, weight, physical activity, smoking, family history, serum cholesterol, diabetes mellitus, renal dysfunction, peripheral resistance vessel tone, endothelial dysfunction, autonomic tone, insulin resistance and neurohumoral factors. Hypertension doubles the risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease if not effectively treated^3,4. Globally, elevated blood pressure is the leading risk factor for mortality and morbidity, accounting for 7% of global disability adjusted life years and 9.4 million deaths in 2010⁵. The prevalence of hypertension has been increasing in India. The average prevalence of hypertension in India is 25% in urban and 10% in rural inhabitants⁶. Factors which are attributable to these changes are rapid urbanization, lifestyle changes, dietary changes and increased life expectancy⁷. Epidemiological studies have shown that sedentary life-style and stress are important risk factors for hypertension⁸. A systematic review on the prevalence of HTN in India, for studies published between 1969 and July 2011, reported a range between 13.9 to 46.3% and 4.5 to 58.8% in urban and rural areas of India, respectively⁹.So we have done study to understand the pattern of drug and concomitant drugs consumed for hypertension at tertiary health care centre.

METHODOLOGY

The Present study was undertaken by the department of Pharmacology in collaboration with the department of Medicine on newly diagnosed patients of Hypertension attending Medicine outpatient department of HKE society’s Basaveshwara Teaching and General hospital, attached to M.R.Medical College, Kalaburagi a for a period of 12 months from January 2017- December 2017. After approval by the Institutional Ethics Committee (IEC), 100 adult patients aged 18-60 yrs of either sex of newly diagnosed mild and moderate hypertensive patients were included. whilePatients aged <18 years and >60 years, History of severe hepatic, renal disease and severe cardiac disease, Pregnant and lactating mothers, Major Depressive Disorder with psychotic symptoms were excluded from the study. Here the main treatment group i.e. Cilnidipine and Amlodipine were prepared and pattern of concomitant drugs given them were also retrieved.The statistics presented in the percentages and tabular form.

RESULTS

The present study was conducted on 100 patients aged between 18-60 years of age of either sex, diagnosed to be suffering from mild to moderate hypertension, and prescribed either Cilnidipine or Amlodipine. The results obtained from our study have been tabulated along with appropriate graphical representation below

Table 1: Age wise distribution of patients among two groups

The mean age in the patients received Cilnidipinewas 42.98 ± 8.35 and Amlodipine was 44.48 ± 9.03.

Table 2: Sex wise distribution of patients among two groups

Out of total 100 patients, Male: Female ratio of 67:33 was found in the patients enrolled for our study

Table 3: Distribution of patients according to Grade of Hypertension

Both the groups had more patients with moderate elevation of blood pressure

Table 4: concomitantmedications prescribed in patients of two group