DRUG USAGE PATTERN OF ANTIHYPERTENSIVES IN DIABETIC PATIENTS – A CROSS-SECTIONAL OPD-BASED STUDY IN A TERTIARY CARE SET-UP

SHIKHA KUMARI; AMIT KUMAR; SUSHANTA KUMAR BORDOLOI

doi:10.22159/ajpcr.2022.v15i12.45958

Authors

SHIKHA KUMARI Department of Pharmacology, M.G.M Medical College and L.S.K. Hospital, Kishanganj, Bihar, India.
AMIT KUMAR Private Practitioners, Department of Internal Medicine, Kishanganj, Bihar, India.
SUSHANTA KUMAR BORDOLOI Department of Pharmacology, M.G.M Medical College and L.S.K. Hospital, Kishanganj, Bihar, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i12.45958

Keywords:

Hypertension, Diabetes, Macrovascular complications, Coronary artery disease, Peripheral vascular disease, Metformin, protein, Calcium channel blockers, Sulfonylureas, DDP4 inhibitors, Alpha-glucosidase inhibitors

Abstract

Objective: The objective of this study was to observe the pattern of utilization of different groups of antihypertensive drugs in patients with diabetes in a tertiary care hospital and correlate the data obtained from the study.

Methods: It was an institution-based cross-sectional study; the present study was carried out at M.G.M. Medical College and L.S.K. Hospital in Kishanganj, Bihar, in the Department of Pharmacology. This study included 520 diabetes mellitus patients with hypertensive disorders who presented to the Department of Medicine at M.G.M. Medical College and L.S.K. Hospital, Kishanganj, during the study period (June 2021–May 2022).

Results: When we appeared at the prescribing patterns of antidiabetic drugs, we found that metformin was the most common (80%), followed by sulfonylureas (65%), DDP4 inhibitors (56.7%), and alpha-glucosidase inhibitors (5%). An evaluation of the pattern of hypertensive drugs prescribed to study subjects revealed that monotherapy was the preferred option (77.1%) over combination therapy (22.9%). Telmisartan (32.4%) is the most common drug used in monotherapy among the study subjects included in the present study, followed by Amlodipine (27.4%) and Metoprolol (14.5%), Bisoprolol (14.5%), and Clinidipine (11.2%), respectively.

Conclusion: The evaluation of all medications prescribed was reasonable and in compliance with JNC-8 treatment guidelines. Further, research is needed to qualify the rationale for drug choice based on demographics, economic status, comorbidities, and complications to provide additional insight into antihypertensive drug prescribing patterns in people with diabetes so the results can be translated for broader and more real benefits can become a medical community.

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References

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047-53. doi: 10.2337/diacare.27.5.1047

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet 2005;365:217-23. doi: 10.1016/S0140-6736(05)17741-1

Sicree R, Shaw J, Zimmet P. Diabetes and impaired glucose tolerance. In: Gan D, editor. Diabetes Atlas. International Diabetes Federation. 3rd ed. Brussels, Belgium: International Diabetes Federation; 2006. p. 15-103. Available from: https://www.bms.com/sbin2-930229-45-4

Miller GJ, Maude GH, Beckles GL. Incidence of hypertension and non-insulin dependent diabetes mellitus and associated risk factors in a rapidly developing Caribbean community: The St James survey, Trinidad. J Epidemiol Community Health 1996;50:497-504. doi: 10.1136/jech.50.5.497

Wright JT Jr., Fine LJ, Lackland DT, Ogedegbe G, Himmelfarb CR. Evidence supporting a systolic blood pressure goal of less than 150 mm Hg in patients aged 60 years or older: The minority view. Ann Intern Med 2014;160:499-503. doi: 10.7326/M13-2981

El-Hazmi MA, Warsy AS. Association of hypertension and non-insulin-dependent diabetes mellitus in the Saudi population. Ann Saudi Med 2001;21:5-8. doi: 10.5144/0256-4947.2001.5

Sowers JR, Haffner S. Treatment of cardiovascular and renal risk factors in the diabetic hypertensive. Hypertension 2002;40:781-8. doi: 10.1161/01.HYP.0000042097.39655.B7

Kaur SS, Gupta S, Kumar D, Lal M, Gilani Z. Prescribing pattern of antihypertensive drugs in a tertiary care hospital in Jammu-a descriptive study. JK Pract 2012;17:38-41.•https://www.researchgate. net/publication/279961794

Mohan S, Campbell N, Chockalingam A. Time to effectively address hypertension in India. Indian J Med Res 2013;137:627-31. PMCID: PMC3724241

Anchal R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: A systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens 2014;32:1170-7. doi: 10.1097/HJH.0000000000000146

Lackland DT, Weber MA. Global burden of cardiovascular disease and stroke: hypertension at the core. Can J Cardiol 2015;31:569-71. doi: 10.1016/j.cjca.2015.01.009

World Health Organization. Global Health Observatory (GHO) Data: Raised Blood Pressure 2018. Geneva: World Health Organization. https://www.who.int/gho/ncd/risk_factors/blood_pressure_ prevalence/en

Fuller J, Stevens LK, Chaturvedi N, Holloway JF. Antihypertensive therapy for preventing cardiovascular complications in people with diabetes mellitus. Cochrane Database Syst Rev 2000;2:CD002188. doi: 10.1002/14651858.CD002188

Seen JJ. Essential hypertension. In: Koda-Kimble MA, Young, LY, Alldredge BK, Corelli RL, Guglielino BJ, Kradjan WA, et al, editors. Applied Therapeutics. The Clinical Use of Drugs. 9th ed. New York: Lippincott Willams and Wilkins; 2009. p. 13-1-41.

Hiremath JS, Katekhaye VM, Chamle VS, Jain RM, Bhargava AI. The current practice of hypertension in India: Focus on blood pressure goals. J Clin Diagn Res 2016;10:OC25-8. doi: 10.7860/ JCDR/2016/21783.8999

Johnson ML, Singh H. Patterns of antihypertensive therapy among patients with diabetes. J Gen Intern Med 2005;20:842-6. doi: 10.1111/j.1525-1497.2005.0170.x

Dhanaraj E, Raval A, Yadav R, Bhansali A, Tiwari P. Prescription pattern of antihypertensive agents in T2DM patients visiting tertiary care centre in North India. Int J Hypertens 2012;2012:520915. doi: 10.1155/2012/520915

Alavudeen SS, Alakhali KA, Ansari SM, Khan NA. Prescribing pattern of antihypertensive drugs in diabetic patients of Southern province, kingdom of Saudi Arabia. Ars Pharm 2015;56:109-14. doi: 10.4321/ S2340-98942015000200005

Bhore AS, Khandare K, Bansod KA. Prescription pattern and rationality of antihypertensive drugs in patients of Type 2 diabetes with hypertension: A pilot study. Int J Res Med Sci 2019;7:982-6. doi: 10.18203/2320-6012.ijrms20191299